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NPI Code Detail

MEDICARE: WENDY WARREN COATES LMFT

MEDICARE: WENDY WARREN COATES LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0717001275VA

General Provider Information

NPI Number : 1992143143
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY WARREN COATES LMFT
Provider Business Mailing Address
First Line : 199 LIBERTY ST SW
Second Line :
City : LEESBURG
State : VA
Zip : 20175-2715
Country : US
Telephone Number : 703-776-9019
Fax Number :
Provider Business Practice Location Address
First Line : 199 LIBERTY ST SW
Second Line :
City : LEESBURG
State : VA
Zip : 20175-2715
Country : US
Telephone Number : 703-776-9019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2013
Last Update Date : 01/27/2017

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