Provider Demographics
NPI:1720101538
Name:COOGAN, MARGARET E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:E
Last Name:COOGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5233 WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1113
Mailing Address - Country:US
Mailing Address - Phone:703-527-9030
Mailing Address - Fax:703-527-1900
Practice Address - Street 1:5233 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1113
Practice Address - Country:US
Practice Address - Phone:703-527-9030
Practice Address - Fax:703-527-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA667763Medicare ID - Type Unspecified