Provider Demographics
NPI:1447434972
Name:COLE, FLOYD WALLACE (PHD)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:WALLACE
Last Name:COLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7984 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4718
Mailing Address - Country:US
Mailing Address - Phone:502-426-2777
Mailing Address - Fax:502-426-2776
Practice Address - Street 1:7984 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4718
Practice Address - Country:US
Practice Address - Phone:502-426-2777
Practice Address - Fax:502-426-2776
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCPRC14203101YM0800X
TN2334101YM0800X
IN99081736A103TC0700X
KY275501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health