Individual
MRS. TAVITA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1926 VERMILLION VIEW ST, FRESNO, TX 77545-2109
(713) 427-9605
Mailing address
1926 VERMILLION VIEW ST, FRESNO, TX 77545-2109
(713) 427-9605
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
27765597
TX
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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