Healthcare Provider Details

I. General information

NPI: 1104456714
Provider Name (Legal Business Name): CATHERINE KOCHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8774 YATES DR # 345
WESTMINSTER CO
80031-6958
US

IV. Provider business mailing address

2201 S FRANKLIN ST
DENVER CO
80210-4612
US

V. Phone/Fax

Practice location:
  • Phone: 720-443-2276
  • Fax:
Mailing address:
  • Phone: 832-729-6202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0013983
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: