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General NPI Number Information
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NPI Number | 1467663112
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Entity Type | Individual
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Provider Name | KRISTINE ASH COUGHLIN
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 816 S 5TH ST
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City | MONTROSE
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State | CO
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Zip | 81401-5765
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Country | US
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Telephone | 970-209-0634
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 301
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City | RIDGWAY
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State | CO
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Zip | 81432-0301
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Country | US
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Telephone | 970-209-0634
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Fax | 970-325-4407
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 179
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License Number State | CO
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