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General NPI Number Information
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NPI Number | 1487190427
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Entity Type | Organization
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Legal Business Name | KOTSEN PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 01/15/2017
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Last Update Date | 01/15/2017
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Provider Practice Location Address
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Address Line | 43 SPRING ST
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City | PRINCETON
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State | NJ
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Zip | 08542-6904
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Country | US
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Telephone | 609-577-4727
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Fax |
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Provider Business Mailing Address
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Address Line | 43 SPRING ST
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City | PRINCETON
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State | NJ
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Zip | 08542-6904
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | CHRIS KOTSEN
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Credential |
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Telephone | 609-577-4727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI000354700
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License Number State | NJ
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