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General NPI Number Information
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NPI Number | 1700935418
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Entity Type | Individual
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Provider Name | ALISON B KOEHLER LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4343 OLD GRAND AVE SUITE 107 C
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City | GURNEE
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State | IL
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Zip | 60031-2767
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Country | US
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Telephone | 847-924-4793
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Fax | 847-865-0867
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Provider Business Mailing Address
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Address Line | 17540 W WESTWIND DR
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City | GURNEE
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State | IL
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Zip | 60031-1691
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Country | US
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Telephone | 847-924-4793
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Fax | 847-856-0867
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 04932302
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License Number State | IL
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