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NPI Code Detail

MEDICARE: MARTINA COLEMAN

MEDICARE:   MARTINA  COLEMAN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1992198444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTINA COLEMAN
Provider Business Mailing Address
First Line : 1619 WOOD POINTE LN APT 1
Second Line :
City : MIDLAND
State : MI
Zip : 48642-3381
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 915 COLUMBUS AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-6603
Country : US
Telephone Number : 989-484-4598
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2015
Last Update Date : 10/14/2025

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Directions to “ MARTINA COLEMAN ” Practice Location

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