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General NPI Number Information
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NPI Number | 1932408093
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Entity Type | Individual
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Provider Name | KATHLEEN ANN KOHLER CMT, LMT,LPN,ESTH
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Gender | Female
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 4514 BONITA RD
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City | BONITA
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State | CA
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Zip | 91902-1427
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Country | US
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Telephone | 619-651-6303
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Fax |
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Provider Business Mailing Address
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Address Line | 48 E WHITNEY ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-6130
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Country | US
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Telephone | 619-651-6303
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 17287
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3871
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License Number State | HI
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