Individual
CAROLE ANN COUGHLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAPC, LISAC, CCJP
Contact information
Practice address
5008 W GLENDALE AVE, GLENDALE, AZ 85301-2751
(623) 930-9317
(623) 930-9521
Mailing address
5008 W GLENDALE AVE, GLENDALE, AZ 85301-2751
(623) 930-9317
(623) 930-9521
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC1608
AZ
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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