| Doctor Name: | MS. SUSANNAH CARRIE COASTON |
| NPI Number: | 1801175021 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, PCC-S |
| License Number: | E.0600283-SUPV |
| Business Practice Address: | 43 E Main St Amelia, OH - 451021993 |
| Business Phone Number: | 5139477000 |
| Business Fax Number: | |
| Mailing Address: | 43 E Main St, AMELIA |
| State: | OH |
| Postal Code: | 451021993 |
| Phone Number: | 5139477000 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2011 |
| NPI Last Update Date: | 08/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E.0600283-SUPV |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |