MEDICARE: MR. BRYAN CURTIS KOHRING LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	2011011824	MO

General Provider Information

NPI Number	:	1922476217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRYAN CURTIS KOHRING LCSW

Provider Business Mailing Address
First Line	:	12110 CLAYTON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2516
Country	:	US
Telephone Number	:	314-989-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 WEBER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-5722
Country	:	US
Telephone Number	:	314-550-8858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2015
Last Update Date	:	09/03/2015

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