Individual
DR. JEANINE E. KOTSCHWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2100 S COLUMBIA RD, SUITE 202, GRAND FORKS, ND 58201-5895
(701) 772-1588
(701) 746-6077
Mailing address
2100 S COLUMBIA RD, SUITE 202, GRAND FORKS, ND 58201-5895
(701) 772-1588
(701) 746-6077
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
177
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16917
—
ND
01
—
197M7K0
MN BLUE CROSS
MN
05
—
366850900
—
MN
01
—
KOT22727
ND BLUE CROSS
ND
Enumeration date
07/14/2006
Last updated
09/26/2017
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