Provider Demographics
NPI:1306292784
Name:COLEMAN, CARRIE LYNN (PHD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LYNN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MINGES CREEK PL
Mailing Address - Street 2:APT. E308
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-5716
Mailing Address - Country:US
Mailing Address - Phone:734-649-6132
Mailing Address - Fax:
Practice Address - Street 1:100 MINGES CREEK PL
Practice Address - Street 2:APT. E308
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-5716
Practice Address - Country:US
Practice Address - Phone:734-649-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst