Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 1041C0700X | Clinical Social Worker | 080160 | NY |
NPI | 1992970131 |
---|---|
Provider Name | Mr. Seaghan P Coleman V |
First Address | Buffalo, NY 14214-2154 |
Second Address | Buffalo, NY 14214-2154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 24/05/2016 |