Provider Demographics
NPI:1629741491
Name:COLEMAN, SHEILA
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 QUEENSGATE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-4434
Mailing Address - Country:US
Mailing Address - Phone:410-646-0651
Mailing Address - Fax:443-478-4698
Practice Address - Street 1:638 QUEENSGATE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4434
Practice Address - Country:US
Practice Address - Phone:410-537-0643
Practice Address - Fax:443-478-4698
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251S00000XAgenciesCommunity/Behavioral Health