Individual
SHAWN WESLEY COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, PSYCHOLOGY
Contact information
Practice address
2446 COLEMAN ST, POCATELLO, ID 83201-2103
(208) 406-7994
Mailing address
2446 COLEMAN ST, POCATELLO, ID 83201-2103
(208) 406-7994
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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