Doctor Name: | PEGGY COLEMAN |
NPI Number: | 1427275841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.A.D.C. |
License Number: | 60 |
Business Practice Address: | 600 Denver St Pawnee, OK - 740583522 |
Business Phone Number: | 9187623686 |
Business Fax Number: | 9187622617 |
Mailing Address: | Po Box 122, PAWNEE |
State: | OK |
Postal Code: | 740580122 |
Phone Number: | 9187622944 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 60 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |