Most Relevant Information
Provider Data
NPI Number: | 1003434366 |
Provider Name: | KIMARA MELISSA COLEMAN AMFT |
Entity Type: | Individual |
Taxonomy Code: | 106H00000X |
Specialty: | Marriage & Family Therapist |
License Number: | 117344 |
Most Important Dates
Enumeration Date: | 07/13/2020 |
Last Updated: | 07/06/2023 |
Provider Practice Location
31772 CASINO DR
LAKE ELSINORE
CA
925304502
Practice Location Phone/Fax
Phone: | 9516749400 |
Fax: |
Provider Mailing Location
31772 CASINO DR
LAKE ELSINORE
CA
925304502
Provider Mailing Phone/Fax
Phone: | 9516749400 |
Fax: |