Provider Demographics
NPI:1306657606
Name:COLEMAN, CECILIA JEAN
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:JEAN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17422 AUTUMN TRAILS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1104
Mailing Address - Country:US
Mailing Address - Phone:832-443-7282
Mailing Address - Fax:
Practice Address - Street 1:17422 AUTUMN TRAILS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1104
Practice Address - Country:US
Practice Address - Phone:832-443-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional