| Doctor Name: | DR. SAMANTHA WESLEY KOHN |
| NPI Number: | 1013018589 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 016889 |
| Business Practice Address: | 790 Route 211 E Middletown, NY - 109411448 |
| Business Phone Number: | 8452832544 |
| Business Fax Number: | |
| Mailing Address: | 11 Trails Point Dr, CAMPBELL HALL |
| State: | NY |
| Postal Code: | 109162306 |
| Phone Number: | 8452949469 |
| Fax Number: | 8452949469 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 016889 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |