Individual
MR. JONATHAN RYAN COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTTS-M
Contact information
Practice address
361 PLANTATION ST, UMASS MEMORIAL MEDICAL CENTER, PSYCHIATRY, WORCESTER, MA 01605-2323
(508) 856-2537
(508) 856-5320
Mailing address
361 PLANTATION ST, UMASS MEMORIAL MEDICAL CENTER, PSYCHIATRY, WORCESTER, MA 01605-2323
(508) 856-2537
(508) 856-5320
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196
CTTS-M
MA
Enumeration date
02/24/2010
Last updated
02/24/2010
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