Individual
JALISA MARIE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC, LCMHC
Contact information
Practice address
1511 KENILWORTH AVE # UNITE315, CHARLOTTE, NC 28203-1508
(196) 219-7719
Mailing address
1511 KENILWORTH AVE # UNITE315, CHARLOTTE, NC 28203-1508
(196) 219-7719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13386
NC
Other
Enumeration date
10/11/2017
Last updated
10/15/2021
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