Most Relevant Information
Provider Data
| NPI Number: | 1003524307 |
| Provider Name: | MIRACLE JADE COLEMAN LMSW, MPH, MA |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 114531 |
Most Important Dates
| Enumeration Date: | 11/07/2022 |
| Last Updated: | 11/07/2022 |
Provider Practice Location
463 LINCOLN PL # 180
BROOKLYN
NY
112386201
Practice Location Phone/Fax
| Phone: | 2063108745 |
| Fax: |
Provider Mailing Location
463 LINCOLN PL # 180
BROOKLYN
NY
112386201
Provider Mailing Phone/Fax
| Phone: | 2063108745 |
| Fax: |