Individual
TIMOTHY COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 E MAIN ST, MEDFORD, OR 97504-7136
(541) 842-7704
(541) 842-7640
Mailing address
900 E MAIN ST, MEDFORD, OR 97504-7136
(541) 842-7705
(541) 842-7640
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4533
OR
Other
Enumeration date
11/05/2015
Last updated
05/03/2018
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