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General NPI Number Information
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NPI Number | 1013018589
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Entity Type | Individual
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Provider Name | SAMANTHA WESLEY KOHN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 3136 ROUTE 207 SUITE 107
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City | CAMPBELL HALL
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State | NY
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Zip | 10916
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Country | US
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Telephone | 845-283-2544
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Fax | 845-360-5834
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Provider Business Mailing Address
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Address Line | 11 TRAILS POINT DR
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City | CAMPBELL HALL
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State | NY
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Zip | 10916-2306
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Country | US
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Telephone | 845-294-9469
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Fax | 845-294-9469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 016889
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License Number State | NY
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