Provider Demographics
NPI:1932922192
Name:COLE, JONQUANAE
Entity type:Individual
Prefix:
First Name:JONQUANAE
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JONQUANAE
Other - Middle Name:
Other - Last Name:FYFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2732 BRADEN WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8572
Mailing Address - Country:US
Mailing Address - Phone:571-484-1955
Mailing Address - Fax:
Practice Address - Street 1:2732 BRADEN WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8572
Practice Address - Country:US
Practice Address - Phone:571-484-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker