Individual
MRS. MELICIA DIAN COONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
CTA0000000819
TN
174400000X
Specialist
Primary
MT0000002474
TN
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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