Individual
HEATHER COFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2106 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-9004
(479) 229-2000
Mailing address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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