Organization
CENTRUM COUNSELING & PHOBIA CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN R COHEN PSYD (PSYCHOLOGIST PRESIDENT OF CORP)
(708) 386-7974
Entity
Organization
Contact information
Practice address
1101 LAKE ST, #201, OAK PARK, IL 60301
(708) 386-7974
(708) 386-7977
Mailing address
1101 LAKE ST, #201, OAK PARK, IL 60301
(708) 386-7974
(708) 386-7977
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
I1071003499
IL
Other
Enumeration date
02/05/2007
Last updated
08/22/2007
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