Provider Demographics
NPI:1326258161
Name:COCO, MARY QUINN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:QUINN
Last Name:COCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13264 KERRVILLE FOLKWAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7842
Mailing Address - Country:US
Mailing Address - Phone:512-258-0516
Mailing Address - Fax:512-258-0516
Practice Address - Street 1:13264 KERRVILLE FOLKWAY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7842
Practice Address - Country:US
Practice Address - Phone:512-258-0516
Practice Address - Fax:512-258-0516
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15211101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional