Individual
ANTHONY LEE COGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 W SCHOOL AVE, VISALIA, CA 93291-4925
(559) 625-4100
Mailing address
120 W SCHOOL AVE, VISALIA, CA 93291-4925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1319890818
RESIDENTIAL ALCOHOL AND DRUG TECH -1
CA
Enumeration date
08/25/2020
Last updated
08/25/2020
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