Merritt Coughlan-Smith
Psychologist, School in Maywood, IL. Individual provider (NPI-1).
NPI number1194472936
StatusActive
Last updated in NPPESMar 2, 2022
Details
- NPI
- 1194472936
- Entity type
- Individual (NPI-1)
- Name
- Merritt Coughlan-Smith
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 2, 2022
- Certification date
- Mar 2, 2022
- Last updated
- Mar 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | – | – | Yes |
Practice location
311 Washington BlvdMaywood, IL 60153-2154
Phone 651-425-8667
Mailing address
836 S Maple Ave Apt 20Oak Park, IL 60304-1071
Phone 651-425-8667
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