Individual
CASSANDRA C COATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
134 MAIN ST APT 117, RACINE, WI 53403-4623
(262) 822-7740
Mailing address
134 MAIN ST APT 117, RACINE, WI 53403-4623
(262) 822-7740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18959-130
WI
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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