Provider Demographics
NPI:1003019084
Name:COLEMAN, REGINALD H (BA)
Entity Type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:H
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G-3163 FLUSHING RD
Mailing Address - Street 2:STE 106
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504
Mailing Address - Country:US
Mailing Address - Phone:810-249-9924
Mailing Address - Fax:
Practice Address - Street 1:G-3163 FLUSHING RD
Practice Address - Street 2:STE 106
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504
Practice Address - Country:US
Practice Address - Phone:810-249-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)