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General NPI Number Information
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NPI Number | 1396630588
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Entity Type | Individual
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Provider Name | DANIELLA ADELE COUGHLIN CRC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1401 SW 1ST ST STE 209
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City | MIAMI
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State | FL
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Zip | 33135-2261
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Country | US
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Telephone | 305-902-3880
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Fax | 305-902-3885
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Provider Business Mailing Address
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Address Line | 7929 KESSLER CT
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City | COLUMBUS
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State | GA
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Zip | 31905-9562
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Country | US
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Telephone | 707-732-1099
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 730700
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License Number State |
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