Individual
TIMOTHY KOEHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
142 CROSS LANES DR, NITRO, WV 25143-1007
(304) 769-8484
Mailing address
142 CROSS LANES DR, NITRO, WV 25143-1007
(304) 769-8484
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-9168
WV
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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