Individual
MRS. STACY COFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
788 CHERRY TREE CT, HANOVER, PA 17331-7901
(717) 632-5552
(717) 632-2315
Mailing address
788 CHERRY TREE CT, HANOVER, PA 17331-7901
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1957642
MEDICARE
PA
Enumeration date
12/16/2009
Last updated
12/16/2009
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