Individual
MICKEY DIANE COAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 W DELAWARE AVE, PENNINGTON, NJ 08534-1601
(609) 609-7712
Mailing address
112 W DELAWARE AVE, PENNINGTON, NJ 08534-1601
(609) 609-7712
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46901
MEDICAL REIMBURSEMENT CONSULTANTS, INC.
IN
Enumeration date
01/30/2016
Last updated
01/30/2016
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