Provider Demographics
NPI:1326110800
Name:COUGHLIN-MARTIN, BARBARA J (RN,LCMT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:COUGHLIN-MARTIN
Suffix:
Gender:F
Credentials:RN,LCMT
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:COUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, LCMT
Mailing Address - Street 1:33 THOREAU DR
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-2410
Mailing Address - Country:US
Mailing Address - Phone:508-237-2677
Mailing Address - Fax:
Practice Address - Street 1:708 ROUTE 134 UNIT 6
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3062
Practice Address - Country:US
Practice Address - Phone:508-237-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA141724163W00000X
MA265225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163W00000XNursing Service ProvidersRegistered Nurse