Provider Demographics
NPI:1386512457
Name:COFFMAN, AMANII S
Entity type:Individual
Prefix:
First Name:AMANII
Middle Name:S
Last Name:COFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1899 BEAUFAITE DRIVE GROSSE POINTE WOOD
Mailing Address - Street 2:
Mailing Address - City:1899 BEAUFAIT DRIVE GROSSE POINTE WOODS,
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:800-385-1035
Mailing Address - Fax:
Practice Address - Street 1:20700 CIVIC CENTER DR, SOUTHFIELD, MI 48076
Practice Address - Street 2:
Practice Address - City:SOUTHFEILD
Practice Address - State:MI
Practice Address - Zip Code:48076
Practice Address - Country:US
Practice Address - Phone:800-385-1035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician