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Individual

MRS. JENNIFER SHAVONNE COUGHLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LSW

Contact information

Practice address
7727 DORCAS ST, PHILADELPHIA, PA 19111-2824
(215) 806-1995
(215) 437-7520
Mailing address
7727 DORCAS ST, PHILADELPHIA, PA 19111-2824
(215) 806-1995
(215) 437-7520

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL05324100
NJ

Other

Enumeration date
06/01/2009
Last updated
06/01/2009
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