Provider Demographics
NPI:1417208059
Name:COFER, DONALD R SR (MFTT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:COFER
Suffix:SR
Gender:M
Credentials:MFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 E LUGONIA AVE
Mailing Address - Street 2:APT D
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2699
Mailing Address - Country:US
Mailing Address - Phone:909-583-7786
Mailing Address - Fax:909-235-1984
Practice Address - Street 1:1164 E LUGONIA AVE
Practice Address - Street 2:APT D
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2699
Practice Address - Country:US
Practice Address - Phone:909-583-7786
Practice Address - Fax:909-235-1984
Is Sole Proprietor?:No
Enumeration Date:2012-09-22
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist