Provider Demographics
NPI:1477146702
Name:CHERI N. KOINIS, PHD
Entity Type:Organization
Organization Name:CHERI N. KOINIS, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:N
Authorized Official - Last Name:KOINIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-507-9700
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-0532
Mailing Address - Country:US
Mailing Address - Phone:505-507-9700
Mailing Address - Fax:
Practice Address - Street 1:8 ANASAZI RD
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043-8741
Practice Address - Country:US
Practice Address - Phone:505-404-8631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health