Individual
JAMIE COULTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
671 S LEWIS AVE, WAUKEGAN, IL 60085-6101
(847) 782-4237
Mailing address
671 S LEWIS AVE, WAUKEGAN, IL 60085-6101
(847) 782-4237
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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