Provider Demographics
NPI:1316989924
Name:COUGHLIN, WENDY E (PHD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:E
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BELCHER RD S
Mailing Address - Street 2:SUITE E
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3356
Mailing Address - Country:US
Mailing Address - Phone:727-532-1997
Mailing Address - Fax:727-524-1332
Practice Address - Street 1:1101 BELCHER RD S
Practice Address - Street 2:SUITE E
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3356
Practice Address - Country:US
Practice Address - Phone:727-532-1997
Practice Address - Fax:727-524-1332
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling