Coquus

NPI #1205079746 in Waldorf, Maryland

Provider Information

NPI Number: 1205079746
Entity Type: Organization
Organization Name: Coquus
Primary Specialty: Psychologist
Enumeration Date: Apr 14, 2009
Last Updated: Jun 24, 2009

Practice Location

Address: 21 INDUSTRIAL PARK DR
Address 2: SUITE 202 F
City: Waldorf
State: Maryland
ZIP Code: 20602-2751
Phone: (301) 848-0461

Authorized Official

Name: DR. PATRICIA VANCE, PH.D.
Title: DIRECTOR
Phone: (301) 848-0461

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Psychologist	103T00000X	Primary

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