Individual
MR. GARY JAMES COENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
313 PRICE PL, SUITE 209, MADISON, WI 53705-3299
(608) 213-3158
Mailing address
313 PRICE PL, SUITE 209, MADISON, WI 53705-3299
(608) 213-3158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14254-132
WI
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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