Individual
CYARA LANETTE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S, MA, BCBA, LBA
Contact information
Practice address
634 N MAIN ST STE 4, O FALLON, IL 62269-3746
(314) 584-9912
Mailing address
106 LYNN ST, LEBANON, IL 62254-1454
(314) 584-9912
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-51903
—
106S00000X
Behavior Technician
RBT-15-06946
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-51903
BCBA
—
01
—
61219373
LBA
WA
01
—
BACB312357
RBT
IL
01
—
RBT-15-06946
RBT
IL
Enumeration date
12/14/2017
Last updated
11/07/2022
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