Individual
RENEE M COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1971 21 15/16 ST, RICE LAKE, WI 54868-8583
(715) 234-2122
(715) 234-2122
Mailing address
1971 COUNTRY AIRE DRIVE, RICE LAKE, WI 54868
(715) 234-2122
(715) 234-2122
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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