Individual
MR. WIGBERTO MOISES CORONEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS. CLINICAL PSYCHOL
Contact information
Practice address
1099 HANCOCK RD, BULLHEAD CITY, AZ 86442-5957
(928) 299-3698
Mailing address
1099 HANCOCK RD, BULLHEAD CITY, AZ 86442-5957
(928) 299-3698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2100067
AZ
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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