Healthcare Provider Details

I. General information

NPI: 1851375471
Provider Name (Legal Business Name): STEPHANIE ANNE COHEN MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD #324 ST. VINCENT ONCOLOGY ADMINISTRATION
INDIANAPOLIS IN
46260-4078
US

IV. Provider business mailing address

8402 HARCOURT RD ST. VINCENT ONCOLOGY ADMINISTRATION
INDIANAPOLIS IN
46260-2052
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-3487
  • Fax:
Mailing address:
  • Phone: 317-338-3487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: