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General NPI Number Information
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NPI Number | 1356206957
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Entity Type | Individual
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Provider Name | MARY B COUGHLIN
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 185 LINCOLN ST STE 205
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City | HINGHAM
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State | MA
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Zip | 02043-1741
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Country | US
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Telephone | 781-749-3606
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Fax | 781-749-0054
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Provider Business Mailing Address
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Address Line | 8 EVANGELINE DR
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City | SCITUATE
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State | MA
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Zip | 02066-4059
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 10001833
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License Number State | MA
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