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General NPI Number Information
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NPI Number | 1982839098
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Entity Type | Organization
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Legal Business Name | DR. THEODORA H. KOEHN, P.C.
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 17300 PRESTON RD SUITE 160
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City | DALLAS
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State | TX
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Zip | 75252-5654
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Country | US
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Telephone | 214-435-4620
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Fax | 972-733-6564
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Provider Business Mailing Address
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Address Line | 17300 PRESTON RD SUITE 160
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City | DALLAS
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State | TX
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Zip | 75252-5654
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Country | US
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Telephone | 214-435-4620
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Fax | 972-733-6564
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEODORA HART KOEHN
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Credential | LPC
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Telephone | 214-435-4620
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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 | 19497
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License Number State | TX
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