Healthcare Provider Details

I. General information

NPI: 1972766764
Provider Name (Legal Business Name): ROBIN LYNN COHENOUR SSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 RITTER RD
CALHOUN LA
71225-8240
US

IV. Provider business mailing address

303 RITTER RD
CALHOUN LA
71225-8240
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-7451
  • Fax:
Mailing address:
  • Phone: 318-396-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberAN001852
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: