Individual
MISS CANDACE E COATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4135 N 66TH ST, MILWAUKEE, WI 53216-1172
(414) 899-6183
Mailing address
4135 N 66TH ST, MILWAUKEE, WI 53216-1172
(414) 899-6183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8053-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396179149
—
WI
Enumeration date
08/29/2013
Last updated
05/09/2023
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