Healthcare Provider Details

I. General information

NPI: 1548184864
Provider Name (Legal Business Name): DEIRDRE LEIGH COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6891 N ORACLE RD STE 155
TUCSON AZ
85704-4287
US

IV. Provider business mailing address

10632 E CERULEAN WAY
TUCSON AZ
85747-5891
US

V. Phone/Fax

Practice location:
  • Phone: 520-308-4999
  • Fax:
Mailing address:
  • Phone: 520-240-8245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number22862
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: