Individual
MS. MARIA C COUGHENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
106 SHOPPERS WAY STE 115, BRUNSWICK, GA 31525-0522
(912) 265-7660
(912) 265-7858
Mailing address
106 SHOPPERS WAY STE 115, BRUNSWICK, GA 31525-0522
(912) 265-7660
(912) 265-7858
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003217
GA
103TC1900X
Counseling Psychologist
3585
NC
103TS0200X
School Psychologist
232032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691501868A
—
GA
Enumeration date
10/17/2006
Last updated
03/08/2018
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