Provider Demographics
NPI:1508312547
Name:COYLE, JOANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:COYLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3067
Mailing Address - Country:US
Mailing Address - Phone:484-213-4513
Mailing Address - Fax:610-539-3024
Practice Address - Street 1:2076 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-3067
Practice Address - Country:US
Practice Address - Phone:484-213-4513
Practice Address - Fax:610-539-3024
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100579200103TC0700X
PAPS018063103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical