Provider Demographics
NPI:1568460202
Name:COHEN, LAWRENCE J (PHARMD, BCPP)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:COHEN
Suffix:
Gender:M
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 JESSICA LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3456
Mailing Address - Country:US
Mailing Address - Phone:509-995-9165
Mailing Address - Fax:
Practice Address - Street 1:2400 JESSICA LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3456
Practice Address - Country:US
Practice Address - Phone:509-995-9165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD113131835P1300X
CA319161835P1300X
NV72291835P1300X
WA679671835P1300X
TX557041835P1300X
OK111471835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric