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General NPI Number Information
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NPI Number | 1427176023
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH KOHLBRENNER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 6838 E GENESEE ST
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City | FAYETTEVILLE
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State | NY
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Zip | 13066-1029
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Country | US
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Telephone | 315-727-0476
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Fax | 315-656-3079
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Provider Business Mailing Address
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Address Line | 103 THORNDIKE LN
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City | MINOA
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State | NY
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Zip | 13116-1127
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Country | US
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Telephone | 315-656-3079
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Fax | 315-656-3079
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10758-1
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License Number State | NY
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