Healthcare Provider Details

I. General information

NPI: 1700066560
Provider Name (Legal Business Name): JOEL LAWRENCE COHEN PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 UNIVERSITY BOULEVARD # 157
DENVER CO
80206
US

IV. Provider business mailing address

191 UNIVERSITY BLVD # 157
DENVER CO
80206
US

V. Phone/Fax

Practice location:
  • Phone: 303-761-2005
  • Fax:
Mailing address:
  • Phone: 303-761-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberCO1479
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: