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Individual

MR. BRIAN S COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
3205 MIDVALE DR APT 107, WILMINGTON, NC 28412-3800
(336) 688-2693
Mailing address
3205 MIDVALE DR APT 107, WILMINGTON, NC 28412-3800
(336) 688-2693

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
373H00000X
Day Training/Habilitation Specialist

Other

Enumeration date
08/17/2020
Last updated
08/17/2020
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