Individual
MR. MICHAEL ERIC COFFMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LGSW, CAC,ICADC
Contact information
Practice address
448 LEONARD AVE, FAIRMONT, WV 26554-3843
(304) 366-7174
Mailing address
RR 1 BOX 161, SHINNSTON, WV 26431-9724
(304) 669-4002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06-111
WV
101YA0400X
Addiction (Substance Use Disorder) Counselor
112279
WV
1041C0700X
Clinical Social Worker
Primary
BP00943419
WV
Other
Enumeration date
05/04/2007
Last updated
07/13/2009
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