Individual
MICHAEL COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3101 N CANTERBURY CT, BLOOMINGTON, IN 47404-1500
(812) 650-3032
Mailing address
3101 N CANTERBURY CT, BLOOMINGTON, IN 47404-1500
(812) 650-3032
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
12/02/2021
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