Provider Demographics
NPI:1447466149
Name:KOHLER, RAINER MARIA (LPSYA)
Entity type:Individual
Prefix:
First Name:RAINER MARIA
Middle Name:
Last Name:KOHLER
Suffix:
Gender:M
Credentials:LPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 RICHARDSON DR
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2854
Mailing Address - Country:US
Mailing Address - Phone:781-444-1023
Mailing Address - Fax:781-449-4786
Practice Address - Street 1:110 RICHARDSON DR
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2854
Practice Address - Country:US
Practice Address - Phone:781-444-1023
Practice Address - Fax:781-449-4786
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000204102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst