Provider Demographics
NPI:1821169368
Name:COHEN, KATHLEEN MAHER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MAHER
Last Name:COHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 MCMILLAN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6765
Mailing Address - Country:US
Mailing Address - Phone:805-781-4960
Mailing Address - Fax:805-781-4962
Practice Address - Street 1:2925 MCMILLAN AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6765
Practice Address - Country:US
Practice Address - Phone:805-781-4960
Practice Address - Fax:805-781-4962
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health