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General NPI Number Information
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NPI Number | 1427374404
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Entity Type | Individual
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Provider Name | PEARL AILSA COAKLEY PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | 16701 MELFORD BLVD STE 400
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City | BOWIE
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State | MD
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Zip | 20715-4411
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Country | US
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Telephone | 301-399-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 12530 FAIRWOOD PKWY STE 102231
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City | BOWIE
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State | MD
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Zip | 20720-6356
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Country | US
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Telephone | 301-399-9119
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1000044
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | O3437
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 03437
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810000357
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License Number State | VA
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