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General NPI Number Information
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NPI Number | 1710038278
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Entity Type | Individual
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Provider Name | KIM LESLIE COHEN LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2306 BERLIN TPKE SUITE 101
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City | NEWINGTON
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State | CT
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Zip | 06111-3204
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Country | US
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Telephone | 860-523-9420
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Fax | 860-667-3369
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Provider Business Mailing Address
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Address Line | 31 FARNHAM RD
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1317
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Country | US
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Telephone | 860-233-3161
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Fax |
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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 | 001011
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License Number State | CT
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