Individual
MRS. AMY MARIE COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-SLP
Contact information
Practice address
110 BISHOP ST, WATERTOWN, NY 13601-4604
(315) 486-7641
Mailing address
110 BISHOP ST, WATERTOWN, NY 13601-4604
(315) 486-7641
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
014471-1
NY
Other
Enumeration date
11/02/2008
Last updated
06/19/2012
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