Individual
CARISSA COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD, MC LEAN, VA 22102-4311
(800) 828-5659
Mailing address
6 CARLY CT, MONROE TOWNSHIP, NJ 08831-5900
(732) 425-9167
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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