Provider Demographics
NPI:1821274820
Name:COHN, MARJORIE (PHD)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:COHN
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 1:3250 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 930
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1577
Mailing Address - Country:US
Mailing Address - Phone:213-739-0019
Mailing Address - Fax:213-739-0091
Practice Address - Street 1:3250 WILSHIRE BLVD
Practice Address - Street 2:SUITE 930
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1577
Practice Address - Country:US
Practice Address - Phone:213-739-0019
Practice Address - Fax:213-739-0091
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical