Provider Demographics
NPI:1447290473
Name:KOHLER, DENISE (PHD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:KOHLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10670 WEST PIKE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43746-9769
Mailing Address - Country:US
Mailing Address - Phone:740-787-1326
Mailing Address - Fax:
Practice Address - Street 1:10670 WEST PIKE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:OH
Practice Address - Zip Code:43746-9769
Practice Address - Country:US
Practice Address - Phone:740-787-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5172103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2219272Medicaid
OH2219272Medicaid