Individual
MARK A COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS. ACT. SASSI
Contact information
Practice address
198 MCARTHUR DR., CAMILLA, GA 31730-4952
(229) 221-3456
Mailing address
420 MCKINLEY ST, THOMASVILLE, GA 31792-4952
(229) 221-3456
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
051193795
GA
101YP2500X
Professional Counselor
051193795
GA
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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