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Individual

TAMMY A COFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DT

Contact information

Practice address
2751 W MAIN ST, CARBONDALE, IL 62901-1000
(618) 529-5944
(618) 529-5785
Mailing address
2751 W MAIN ST, CARBONDALE, IL 62901-1000
(618) 529-5944
(618) 529-5785

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
10/24/2008
Last updated
10/24/2008
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