Individual
MRS. WILMA GORDON COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
11 MOUNTAIN AVE STE 101, BLOOMFIELD, CT 06002-2343
(860) 286-0100
(860) 882-1989
Mailing address
11 MOUNTAIN AVE STE 101, BLOOMFIELD, CT 06002-2343
(860) 286-0100
(860) 882-1989
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001307
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7342824
AETNA PIN
CT
Enumeration date
05/09/2007
Last updated
07/08/2007
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