Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PS000714L | PA |
Y | 103TA0700X | Adult Development & Aging Psychologist | PS000714L | PA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PS000714L | PA |
N | 103G00000X | Clinical Psychologist | PS000714L | PA |
N | 103TC0700X | Clinical Psychologist | PS000714L | PA |
NPI | 1164544557 |
---|---|
Provider Name | Dr. Leo Cohen |
First Address | Yardley, PA 19067-4424 |
Second Address | Yardley, PA 19067-4424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 13/07/2007 |