Organization
INTERVENTION SERVICES OF SOUTHEAST ALABAMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSYCA RENAE COLEMAN LICSW-S (THERAPIST)
(334) 406-0816
Entity
Organization
Contact information
Practice address
557 GLOVER AVE, ENTERPRISE, AL 36330-2024
(334) 308-2292
Mailing address
108 CREST HILL DR, ENTERPRISE, AL 36330-4474
(334) 406-0816
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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