Basic Information
| Provider Information | |||||||||
| NPI: | 1326454661 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COATS | ||||||||
| FirstName: | KAMISHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14221 POLK ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331766441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058125721 | ||||||||
| FaxNumber: | 3058469711 | ||||||||
| Practice Location | |||||||||
| Address1: | 14221 POLK ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331766441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058125721 | ||||||||
| FaxNumber: | 3058469711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2014 | ||||||||
| LastUpdateDate: | 07/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YS0200X | N | Behavioral Health & Social Service Providers | Counselor | School | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.