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Individual

JESSYCA RENAE COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
557 GLOVER AVE STE 3, ENTERPRISE, AL 36330-2070
(334) 308-2292
Mailing address
108 CREST HILL DR, ENTERPRISE, AL 36330-4474
(334) 406-0816

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5225G
AL

Other

Enumeration date
04/08/2022
Last updated
06/21/2024
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