Healthcare Provider Details

I. General information

NPI: 1730692179
Provider Name (Legal Business Name): SHARON TOOMEY KOTCH PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 SOCIETY HILL BLVD
CHERRY HILL NJ
08003-2414
US

IV. Provider business mailing address

314 SOCIETY HILL BLVD
CHERRY HILL NJ
08003-2414
US

V. Phone/Fax

Practice location:
  • Phone: 856-979-5558
  • Fax:
Mailing address:
  • Phone: 856-979-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100577300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: