Doctor Name: | SHELLEY COLEMAN |
NPI Number: | 1114312188 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2172 |
Business Practice Address: | 153 Lower Overlook Dr Hurricane, WV - 255269023 |
Business Phone Number: | 3043996842 |
Business Fax Number: | 3045262638 |
Mailing Address: | 153 Lower Overlook Drive, HURRICANE |
State: | WV |
Postal Code: | 25526 |
Phone Number: | 3043996842 |
Fax Number: | 3045262638 |
NPI Enumeration Date: | 04/06/2015 |
NPI Last Update Date: | 04/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |