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General NPI Number Information
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NPI Number | 1922576511
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Entity Type | Organization
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Legal Business Name | JODI COOLMAN, LLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 706 CHIPPEWA SQ STE 208
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City | MARQUETTE
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State | MI
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Zip | 49855-4813
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Country | US
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Telephone | 906-228-8744
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 WILKINSON AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2128
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Country | US
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Telephone | 906-228-8744
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JODI MARIE COOLMAN
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Credential | LMSW
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Telephone | 906-228-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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