Doctor Name: | BRIANNA COFFEY |
NPI Number: | 1457718819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 206 Burwash Ave Savoy, IL - 618749510 |
Business Phone Number: | 2173563400 |
Business Fax Number: | 2178660122 |
Mailing Address: | 206 Burwash Ave, SAVOY |
State: | IL |
Postal Code: | 618749510 |
Phone Number: | 2173563400 |
Fax Number: | 2178660122 |
NPI Enumeration Date: | 01/15/2016 |
NPI Last Update Date: | 01/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |