Provider Demographics
NPI:1790798577
Name:KOEHLER, HEIDI JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:JEAN
Last Name:KOEHLER
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:PO BOX 201082
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-1082
Mailing Address - Country:US
Mailing Address - Phone:254-743-1826
Mailing Address - Fax:
Practice Address - Street 1:NORTH TEXAS HEALTH CARE SYSTEM
Practice Address - Street 2:4500 SOUTH LANCASTER ROAD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-857-0829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32139103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling