Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 33317 | TX |
NPI | 1053579854 |
---|---|
Provider Name | Dr. Madelyn Nicole Coleman |
First Address | Houston, TX 77207-3154 |
Second Address | Houston, TX 77060-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 28/05/2008 |