Provider Demographics
NPI:1437203668
Name:COHEN, DIANE (PHD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:COHEN
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 1:700 S 7TH ST # 183
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2119
Mailing Address - Country:US
Mailing Address - Phone:267-477-4140
Mailing Address - Fax:267-477-4101
Practice Address - Street 1:700 S 7TH ST # 183
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-2119
Practice Address - Country:US
Practice Address - Phone:267-477-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016363103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical