| Dominique Coffie | |
|
6727 175th St Tinley Park IL 60477-4041 | |
| (716) 603-9857 | |
| Not Available |
| Full Name | Dominique Coffie |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6727 175th St, Tinley Park, Illinois |
| Authorized Official Name and Position | Dominique Coffie (MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 7166039857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominique Coffie 6727 175th St Tinley Park IL 60477-4041 Ph: (716) 603-9857 | Dominique Coffie 6727 175th St Tinley Park IL 60477-4041 Ph: (716) 603-9857 |
| NPI Number | 1962805176 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 10/01/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962805176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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