Provider Demographics
NPI:1669689535
Name:COFFEL, ERICA L (MHPP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:COFFEL
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 N ROCKINGCHAIR RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8570
Mailing Address - Country:US
Mailing Address - Phone:870-335-6760
Mailing Address - Fax:
Practice Address - Street 1:2420 LINWOOD DR.
Practice Address - Street 2:SUITE 1
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:870-236-5880
Practice Address - Fax:870-236-5757
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator