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Individual
JOHN COFFEY
Active
Individual
JOHN COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW010267L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2321345000
IBC
PA
01
—
7499277
AETNA
PA
Enumeration date
08/31/2006
Last updated
07/08/2007
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