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General NPI Number Information
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NPI Number | 1851796205
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Entity Type | Organization
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Legal Business Name | DR. PATRICIA COUGHLIN
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 48 COLUMBIA ST STE 2
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City | ALBANY
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State | NY
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Zip | 12207-2746
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Country | US
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Telephone | 518-859-3960
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Fax |
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Provider Business Mailing Address
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Address Line | 48 COLUMBIA ST STE 2
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City | ALBANY
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State | NY
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Zip | 12207-2746
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Country | US
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Telephone | 518-859-3960
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. PATRICIA COUGHLIN
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Credential | PH.D.
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Telephone | 518-859-3960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 010001
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License Number State | NY
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