| Mr Coleman Riley Vizcarra, | |
|
904 E. Martin Luther King Dr., Centralia, IL 62801 | |
| (618) 533-1391 | |
| (618) 533-0012 |
| Full Name | Mr Coleman Riley Vizcarra |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 904 E. Martin Luther King Dr., Centralia, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770831893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Coleman Riley Vizcarra, 904 E. Martin Luther King Dr., Centralia, IL 62801 Ph: (618) 533-1391 | Mr Coleman Riley Vizcarra, 904 E. Martin Luther King Dr., Centralia, IL 62801 Ph: (618) 533-1391 |
Travis Merrell Trone I, Counselor Medicare: Not Enrolled in Medicare Practice Location: 628 Tracy Ter, Centralia, IL 62801 Phone: 618-533-2579 | |
Andrea Slater, Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 M L King Dr, Centralia, IL 62801 Phone: 618-533-1391 | |
Mary Gates-gully, MS, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 E. Martin Luther King Drive, Centralia, IL 62801 Phone: 618-533-1391 Fax: 618-533-0012 | |
Mrs. Lolita Isaiah, Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 E. Martin Luther King Drive, Centralia, IL 62801 Phone: 618-533-1391 | |
Sydney Cummins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 E Martin Luther Kind Drive, Centralia, IL 62801 Phone: 618-335-0973 | |
Steffany Slininger, Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 M L King Dr, Centralia, IL 62801 Phone: 618-533-1391 | |
Kelsey Dulle, Counselor Medicare: Not Enrolled in Medicare Practice Location: 904 Martin Luther King Drive, Centralia, IL 62801 Phone: 618-533-1391 Fax: 618-533-0012 |