| Coffman 405 Counseling Llc | |
|
624 W Independence St Ste 105 Shawnee OK 74804-4329 | |
| (405) 481-4120 | |
| Not Available |
| Full Name | Coffman 405 Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 624 W Independence St Ste 105, Shawnee, Oklahoma |
| Authorized Official Name and Position | Shelley L Coffman-talley (LICENCED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4052011722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffman 405 Counseling Llc 2 Lakeview Cir Shawnee OK 74804-3021 Ph: (405) 201-1722 | Coffman 405 Counseling Llc 624 W Independence St Ste 105 Shawnee OK 74804-4329 Ph: (405) 481-4120 |
| NPI Number | 1669043311 |
|---|---|
| Provider Enumeration Date | 07/04/2021 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669043311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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