Individual
MISS JESSIDRA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17615 SW 97TH AVE, PALMETTO BAY, FL 33157-5636
(786) 268-2611
(786) 252-2421
Mailing address
17615 SW 97TH AVE, PALMETTO BAY, FL 33157-5636
(786) 268-2611
(786) 252-2421
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762132900
—
FL
Enumeration date
08/14/2009
Last updated
08/14/2009
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