Provider Demographics
NPI:1881077071
Name:DURMUSOGLU, GOKCE
Entity type:Individual
Prefix:
First Name:GOKCE
Middle Name:
Last Name:DURMUSOGLU
Suffix:
Gender:F
Credentials:
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 341648
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45434-1648
Mailing Address - Country:US
Mailing Address - Phone:937-254-9210
Mailing Address - Fax:937-254-9267
Practice Address - Street 1:9 N EDWIN C MOSES BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-8470
Practice Address - Country:US
Practice Address - Phone:937-254-9210
Practice Address - Fax:937-254-9267
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7310103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist