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Individual

MERRITT COUGHLAN-SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
311 WASHINGTON BLVD, MAYWOOD, IL 60153-2154
(651) 425-8667
Mailing address
836 S MAPLE AVE APT 20, OAK PARK, IL 60304-1071
(651) 425-8667

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
03/02/2022
Last updated
03/02/2022
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