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General NPI Number Information
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NPI Number | 1922318419
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Entity Type | Individual
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Provider Name | MICHELLE ANN COOMES MA, LMFTA
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Gender | Female
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 211 S CENTER ST
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City | STATESVILLE
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State | NC
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Zip | 28677-5873
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Country | US
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Telephone | 704-873-4505
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Fax | 704-873-4508
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Provider Business Mailing Address
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Address Line | 905 N MAIN ST
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City | MOORESVILLE
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State | NC
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Zip | 28115-2355
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Country | US
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Telephone | 704-657-7077
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Fax |
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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 | 7011A
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License Number State | NC
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