Provider Demographics
NPI:1568034056
Name:COE, CAILEE DAWN (BACHLORS)
Entity Type:Individual
Prefix:MISS
First Name:CAILEE
Middle Name:DAWN
Last Name:COE
Suffix:
Gender:F
Credentials:BACHLORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5018
Mailing Address - Country:US
Mailing Address - Phone:918-600-3100
Mailing Address - Fax:
Practice Address - Street 1:7404 W 38TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-4852
Practice Address - Country:US
Practice Address - Phone:918-804-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK083814737171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator