Individual
JAMES ALLEN COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 S GOLD AVE, DEMING, NM 88030-3704
(630) 561-5826
Mailing address
3401 W REDFIELD RD, PHOENIX, AZ 85053-5642
(630) 561-5826
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
02/23/2024
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