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General NPI Number Information
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NPI Number | 1417208059
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Entity Type | Individual
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Provider Name | DONALD R COFER SR. MFTT
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Gender | Male
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Dates
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Enumeration Date | 09/22/2012
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Last Update Date | 09/22/2012
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Provider Practice Location Address
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Address Line | 1164 E LUGONIA AVE APT D
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City | REDLANDS
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State | CA
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Zip | 92374-2699
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Country | US
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Telephone | 909-583-7786
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Fax | 909-235-1984
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Provider Business Mailing Address
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Address Line | 1164 E LUGONIA AVE APT D
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City | REDLANDS
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State | CA
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Zip | 92374-2699
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Country | US
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Telephone | 909-583-7786
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Fax | 909-235-1984
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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