Individual
KAITLYN ANN COUCOULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23000 MOAKLEY ST, SUITE 102, LEONARDTOWN, MD 20650-2915
(301) 475-5555
(301) 475-5914
Mailing address
23000 MOAKLEY ST, SUITE 102, LEONARDTOWN, MD 20650-2915
(301) 475-5555
(301) 475-5914
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06063
MD
Other
Enumeration date
02/23/2016
Last updated
12/09/2016
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