Individual
SANDRA KOFFLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
1518 WALNUT ST, SUITE 607, PHILADELPHIA, PA 19102-3419
(267) 416-0506
(215) 545-2442
Mailing address
1518 WALNUT ST, SUITE 607, PHILADELPHIA, PA 19102-3419
(267) 416-0506
(215) 545-2442
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS002520L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001210737
—
PA
Enumeration date
06/19/2006
Last updated
03/07/2017
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