Provider Demographics
NPI:1003329632
Name:D J KOEHN CONSULTING SERVICES INC.
Entity Type:Organization
Organization Name:D J KOEHN CONSULTING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:571-309-7993
Mailing Address - Street 1:PO BOX 6552
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-7100
Mailing Address - Country:US
Mailing Address - Phone:571-309-7993
Mailing Address - Fax:800-387-5701
Practice Address - Street 1:8359 BEACON BLVD STE 301
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3059
Practice Address - Country:US
Practice Address - Phone:571-309-7993
Practice Address - Fax:800-387-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty