Provider Demographics
NPI:1467146597
Name:KOEHLER, TAYLOR VERONICA (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:VERONICA
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E SCHANTZ AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2224
Mailing Address - Country:US
Mailing Address - Phone:513-515-4654
Mailing Address - Fax:
Practice Address - Street 1:460 WINDSOR PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4111
Practice Address - Country:US
Practice Address - Phone:937-409-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305150101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor