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General NPI Number Information
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NPI Number | 1477146702
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Entity Type | Organization
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Legal Business Name | CHERI N. KOINIS, PHD
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 8 ANASAZI RD
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City | PLACITAS
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State | NM
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Zip | 87043-8741
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Country | US
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Telephone | 505-404-8631
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 532
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City | PLACITAS
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State | NM
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Zip | 87043-0532
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Country | US
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Telephone | 505-507-9700
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. CHERI N. KOINIS
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Credential | PHD
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Telephone | 505-507-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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