Provider Demographics
NPI:1346483575
Name:COE, ISOBELLE SHARON (MA, ADM)
Entity Type:Individual
Prefix:
First Name:ISOBELLE
Middle Name:SHARON
Last Name:COE
Suffix:
Gender:F
Credentials:MA, ADM
Other - Prefix:
Other - First Name:ISOBELLE
Other - Middle Name:SHARON
Other - Last Name:COE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ADM
Mailing Address - Street 1:2960 TONGASS AVE
Mailing Address - Street 2:BEHAVIORAL HEALTH - FIRST FLOOR
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901
Mailing Address - Country:US
Mailing Address - Phone:907-228-4917
Mailing Address - Fax:907-228-4920
Practice Address - Street 1:2960 TONGASS AVE
Practice Address - Street 2:BEHAVIORAL HEALTH - FIRST FLOOR
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901
Practice Address - Country:US
Practice Address - Phone:907-228-4917
Practice Address - Fax:907-228-4920
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
AKCDC ADM 3041101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)