Provider Demographics
NPI:1710278205
Name:TERESA COCHRAN PHD PLLC
Entity Type:Organization
Organization Name:TERESA COCHRAN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-246-7618
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:EAST ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02643-0129
Mailing Address - Country:US
Mailing Address - Phone:508-246-7618
Mailing Address - Fax:
Practice Address - Street 1:45 S ORLEANS RD
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-2422
Practice Address - Country:US
Practice Address - Phone:508-246-7618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9934103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty