Doctor Name: | DR. PETER KOEHN |
NPI Number: | 1487817789 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 071007428 |
Business Practice Address: | 555 N Hayes St Harvard, IL - 600332469 |
Business Phone Number: | 8152123209 |
Business Fax Number: | |
Mailing Address: | 555 N Hayes St, HARVARD |
State: | IL |
Postal Code: | 600332469 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/07/2008 |
NPI Last Update Date: | 07/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071007428 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |