Provider Demographics
NPI:1306672563
Name:COGGAN, ERIN CAITLIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:CAITLIN
Last Name:COGGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 PANTHEON WAY STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2308
Mailing Address - Country:US
Mailing Address - Phone:210-699-8700
Mailing Address - Fax:
Practice Address - Street 1:1380 PANTHEON WAY STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2308
Practice Address - Country:US
Practice Address - Phone:210-699-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40023103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool