Individual
JEAN CARLOS CORONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
508 NEW HOPE RD STE 208, PRINCETON, WV 24740-2271
(304) 887-4799
Mailing address
308 CAHILL DR, PRINCETON, WV 24740-3971
(201) 741-6928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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