Provider Demographics
NPI:1265696249
Name:WILSON COLEMAN, ANNE ELIZABETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:WILSON COLEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:KIMBERLING CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65686-9654
Mailing Address - Country:US
Mailing Address - Phone:417-739-2987
Mailing Address - Fax:
Practice Address - Street 1:2 HICKORY DR
Practice Address - Street 2:
Practice Address - City:KIMBERLING CITY
Practice Address - State:MO
Practice Address - Zip Code:65686-9654
Practice Address - Country:US
Practice Address - Phone:417-739-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008000490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional