Andre Coleman
Rehabilitation Practitioner in San Diego, CA. Individual provider (NPI-1).
NPI number1982108213
StatusActive
Last updated in NPPESMay 3, 2023
Details
- NPI
- 1982108213
- Entity type
- Individual (NPI-1)
- Name
- Andre Coleman
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2018
- Certification date
- May 3, 2023
- Last updated
- May 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
2351 Cardinal LnSan Diego, CA 92123-3743
Phone 858-573-2227
Mailing address
2351 Cardinal LnSan Diego, CA 92123-3743
Phone 858-573-2227
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