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General NPI Number Information
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NPI Number | 1376611715
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Entity Type | Individual
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Provider Name | HERB ROGER COHEN MA
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Gender | Male
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 255 S 17TH ST 1509
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6231
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Country | US
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Telephone | 215-884-8235
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Fax | 215-884-4915
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Provider Business Mailing Address
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Address Line | 61 CHELFIELD RD
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City | GLENSIDE
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State | PA
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Zip | 19038-1401
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Country | US
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Telephone | 215-884-8235
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Fax | 214-884-4915
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000308
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License Number State | PA
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