Carissa Coughlin

NPI #1578109435 in Mc Lean, Virginia

Provider Information

NPI Number: 1578109435
Entity Type: Individual
Name: Carissa Coughlin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Nov 25, 2019
Last Updated: Nov 25, 2019

Practice Location

Address: 1651 OLD MEADOW RD
City: Mc Lean
State: Virginia
ZIP Code: 22102-4311
Phone: (800) 828-5659

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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