Doctor Name: | RICHARD KENNETH KOEPKE |
NPI Number: | 1023295003 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., M.DIV |
License Number: | 000551 |
Business Practice Address: | 57 Labelle Ter Amherst, NY - 142281330 |
Business Phone Number: | 7166885002 |
Business Fax Number: | |
Mailing Address: | 57 Labelle Ter, AMHERST |
State: | NY |
Postal Code: | 142281330 |
Phone Number: | 7166885002 |
Fax Number: | |
NPI Enumeration Date: | 01/22/2008 |
NPI Last Update Date: | 01/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000551 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |