Doctor Name: | EVAN COATES |
NPI Number: | 1063561462 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 6615287-3501 |
Business Practice Address: | 1790 N State St Orem, UT - 840572025 |
Business Phone Number: | 8012248255 |
Business Fax Number: | 8012248301 |
Mailing Address: | 1790 N State St, OREM |
State: | UT |
Postal Code: | 840572025 |
Phone Number: | 8012248255 |
Fax Number: | 8012248301 |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 06/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6615287-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |