Doctor Name: | DR. KOICHI YOSHIKAWA |
NPI Number: | 1427443787 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NCSP |
License Number: | C0721014002030 |
Business Practice Address: | 1007 N Main St Dayville, CT - 062412170 |
Business Phone Number: | 8607742020 |
Business Fax Number: | |
Mailing Address: | 303 Putnam Road, PLAINFIELD |
State: | CT |
Postal Code: | 06387 |
Phone Number: | 8605646100 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2015 |
NPI Last Update Date: | 04/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | C0721014002030 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |