Provider Demographics
NPI:1336115930
Name:COUCHMAN, JEAN Z (MS)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:Z
Last Name:COUCHMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:ZUPPARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:14408 SOMMERVILLE COURT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-794-9087
Mailing Address - Fax:804-794-9089
Practice Address - Street 1:14408 SOMMERVILLE COURT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113
Practice Address - Country:US
Practice Address - Phone:804-794-9087
Practice Address - Fax:804-794-9089
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000203231H00000X
VA2101000556231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist