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NPI Code Detail

MEDICARE: COURTNEY COGGAN

MEDICARE:   COURTNEY  COGGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1861920803
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY COGGAN
Provider Business Mailing Address
First Line : 3517 GOLDEN EAGLE DR
Second Line :
City : LAND O LAKES
State : FL
Zip : 34639-9551
Country : US
Telephone Number : 941-740-7600
Fax Number :
Provider Business Practice Location Address
First Line : 1514 N FLORIDA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33602-2602
Country : US
Telephone Number : 941-740-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 06/02/2017

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Directions to “ COURTNEY COGGAN ” Practice Location

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