Provider Demographics
NPI:1134960859
Name:COYL, SAMUEL DAVID
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:DAVID
Last Name:COYL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010A KOHN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9605
Mailing Address - Country:US
Mailing Address - Phone:717-712-2966
Mailing Address - Fax:
Practice Address - Street 1:2010A KOHN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9605
Practice Address - Country:US
Practice Address - Phone:717-712-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health