Individual
DONNA RENEE COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
802 OAK ST, KENOVA, WV 25530-1519
(304) 761-0611
Mailing address
605 CYPRESS ST, RAVENSWOOD, WV 26164-1403
(304) 761-0611
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-9144
WV
Other
Enumeration date
11/21/2022
Last updated
12/21/2022
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