Individual
STEPHEN A KOSCHERAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
16 COMMUNITY LN, SOUTHWEST HARBOR, ME 04679-4273
(207) 244-5630
(207) 244-4418
Mailing address
10 WAYMAN LN, BAR HARBOR, ME 04609-1625
(207) 288-5081
(207) 288-8600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0042341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790764512-009
—
ME
Enumeration date
01/24/2006
Last updated
03/25/2013
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