Provider Demographics
NPI:1679731236
Name:COATES, JOANN M (PHDPC)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:M
Last Name:COATES
Suffix:
Gender:F
Credentials:PHDPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NE LOOP 410
Mailing Address - Street 2:SUITE 504
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1537
Mailing Address - Country:US
Mailing Address - Phone:210-822-2622
Mailing Address - Fax:210-828-0349
Practice Address - Street 1:1100 NE LOOP 410
Practice Address - Street 2:SUITE 504
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1537
Practice Address - Country:US
Practice Address - Phone:210-822-2622
Practice Address - Fax:210-828-0349
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health