Provider Demographics
NPI:1548577406
Name:COLEMAN, PATRISA YVETTE (BS)
Entity Type:Individual
Prefix:MS
First Name:PATRISA
Middle Name:YVETTE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 NW 57TH WAY
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2420
Mailing Address - Country:US
Mailing Address - Phone:954-608-2793
Mailing Address - Fax:954-831-6474
Practice Address - Street 1:5600 NW 57TH WAY
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2420
Practice Address - Country:US
Practice Address - Phone:954-608-2793
Practice Address - Fax:954-831-6474
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health