Individual
MARY COUGHLIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
398 NEPONSET AVE, DORCHESTER, MA 02122-3134
(617) 282-3200
(617) 282-7928
Mailing address
55 HODGKINSON ST, QUINCY, MA 02169-5907
(617) 481-1904
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
169259
MA
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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