Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1179 | KY |
NPI | 1174627558 |
---|---|
Provider Name | Sarah Katherine Koster |
First Address | Ashland, KY 41105-0790 |
Second Address | Ashland, KY 41102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 16/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000524047 | ANTHEM BCBS (01) | |
11816327 | CAQH (01) | |
7100283550 | (05) | KY |