Provider Demographics
NPI:1396029070
Name:COUGHLIN, CATHERINE JOANNE (MED)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JOANNE
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1849
Mailing Address - Country:US
Mailing Address - Phone:207-299-2466
Mailing Address - Fax:
Practice Address - Street 1:88 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1849
Practice Address - Country:US
Practice Address - Phone:207-299-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME399549235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist