Provider Demographics
NPI:1447620109
Name:COHAN, EMMA (PSYD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:COHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 N US HIGHWAY 287 STE 200
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2615
Mailing Address - Country:US
Mailing Address - Phone:503-706-6625
Mailing Address - Fax:
Practice Address - Street 1:792 S BERMONT AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1519
Practice Address - Country:US
Practice Address - Phone:503-706-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORA080070OtherDRIVER LICENSE