Individual
MR. COLTEN DEAN COFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCSW
Contact information
Practice address
12145 WESTERN AVE, BLUE ISLAND, IL 60406-1387
(773) 537-3992
Mailing address
1132 W ARGYLE ST # 2E, CHICAGO, IL 60640-3610
(312) 213-4871
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150102660
IL
1041C0700X
Clinical Social Worker
Primary
149021134
IL
Other
Enumeration date
11/06/2017
Last updated
04/09/2019
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