Individual
TINA VANESSA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1400 NOYES ST, UTICA, NY 13502
(315) 738-4435
Mailing address
106 ROOSEVELT DR, UTICA, NY 13502
(315) 797-4522
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
606069
NY
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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