Individual
MR. KEITH RICHARD KOKSENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
2804 1ST AVE S, SAINT PETERSBURG, FL 33712-1002
(813) 523-7563
Mailing address
2804 1ST AVE S, SAINT PETERSBURG, FL 33712-1002
(727) 201-2485
(813) 272-3766
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9814
FL
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/23/2007
Last updated
06/22/2022
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