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General NPI Number Information
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NPI Number | 1770114647
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Entity Type | Individual
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Provider Name | KATHRIN KOEHLER PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 6557 US HIGHWAY 68 S
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City | WEST LIBERTY
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State | OH
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Zip | 43357-9536
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Country | US
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Telephone | 937-206-3458
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Fax |
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Provider Business Mailing Address
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Address Line | 4674 HOMINY RIDGE RD
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City | SPRINGFIELD
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State | OH
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Zip | 45502-8031
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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 |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4949
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License Number State | OH
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