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Individual
MS. WANDA SUE COBURN
Active
Individual
MS. WANDA SUE COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA., PCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0002808
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000217562
ANTHEM BC BS
OH
01
—
200131
VALUE OPTIONS
OH
05
—
2375451
—
OH
01
—
34-1213335-026
CARESOURCE
OH
01
—
6289134
UNITED BEHAVIORAL HEALTH
OH
Enumeration date
02/22/2007
Last updated
07/09/2007
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