Individual
TERESA RENEE COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
920 SW EMKAY DR STE 104, BEND, OR 97702-1043
(541) 383-0844
Mailing address
601 NW HARMON BLVD, BEND, OR 97703-3060
(541) 383-0844
(541) 383-0840
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195164
—
OR
Enumeration date
04/02/2013
Last updated
09/17/2021
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