Provider Demographics
NPI:1528202371
Name:KOEHLER, DONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:KOEHLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:DON
Other - Middle Name:
Other - Last Name:KOEHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1776 S JACKSON ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3801
Mailing Address - Country:US
Mailing Address - Phone:720-308-3340
Mailing Address - Fax:720-308-3340
Practice Address - Street 1:1776 S JACKSON ST
Practice Address - Street 2:SUITE 211
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:720-308-3340
Practice Address - Fax:720-308-3340
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2009103TC0700X
VA0810003686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical