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Organization
COACHING FOR LIFE
Active
Organization
COACHING FOR LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA COANE (OFFICE MANAGER)
(631) 681-4754
Entity
Organization
Contact information
Practice address
475 E MAIN ST, STE 211, PATCHOGUE, NY 11772-3121
(631) 569-4646
Mailing address
22 VIKING DR, WEST ISLIP, NY 11795-5046
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
082048
NY
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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