MEDICARE: KATHLEEN COUGHLIN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OTL6449	MA

General Provider Information

NPI Number	:	1689511230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN COUGHLIN OTR/L

Provider Business Mailing Address
First Line	:	129 OVERLOOK RD
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-1620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 OVERLOOK RD
Second Line	:
City	:	ARLINGTON
State	:	MA
Zip	:	02474-1620
Country	:	US
Telephone Number	:	781-316-4812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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