Individual
MS. BONNIE ELLEN COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
35 FRONT ST, BINGHAMTON, NY 13905-4703
(607) 722-9190
(607) 722-6245
Mailing address
7 OVERBROOK AVE, BINGHAMTON, NY 13903-1552
(607) 724-3885
(607) 722-6245
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R012554
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
691246
MUP
NY
Enumeration date
11/14/2006
Last updated
07/08/2007
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