MEDICARE: LIAM COYLE

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1699363036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIAM COYLE

Provider Business Mailing Address
First Line	:	3724 GIVEN AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-3411
Country	:	US
Telephone Number	:	203-816-7155
Fax Number	:

Provider Business Practice Location Address
First Line	:	3724 GIVEN AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-3411
Country	:	US
Telephone Number	:	203-816-7155
Fax Number	:

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

Provider Enumeration Date	:	12/31/2020
Last Update Date	:	12/31/2020

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Directions to “ LIAM COYLE ” Practice Location

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