Provider Information for 1225551641
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Mrs. YAZMIN GENESIS COLEMAN LCSW, LISW, LCAS-A
Sex: Female
NPI: 1225551641
Last Updated: 2022-04-21
Certification Date: 2022-04-21
Certification Date: 2022-04-21
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1225551641 | ||||||||||||||||||||
| Enumeration Date | 2017-07-18 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 1003 REXHILL CT APEX, NC 27502-6491 United States Phone: 984-789-2502 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 6410 CODA CT RALEIGH, NC 27616-1998 United States Phone: 984-789-2502 | Fax: | ||||||||||||||||||||
| Secondary Practice Address(es) | 2231 E MILLBROOK RD STE 101 1748 HERITAGE CENTER DR STE 101 | ||||||||||||||||||||
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