Individual
MS. JENNIFER MARIA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
785 WALL ST, O FALLON, IL 62269-1959
(618) 212-3124
Mailing address
1452 SCHWARZ MEADOW DR, O FALLON, IL 62269-6709
(618) 212-3124
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2012036891
MO
1041C0700X
Clinical Social Worker
149021202
IL
Other
Enumeration date
09/26/2013
Last updated
07/11/2019
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