Individual
DR. SUSAN CRYSTAL KOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
30 WARREN ST., BRIGHTON, MA 02135
(617) 254-3800
Mailing address
11 MEADOWBROOK RD, NEEDHAM, MA 02492-1913
(781) 449-4920
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
366
MA
103T00000X
Psychologist
4456
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
366
EDUCATIONAL PSYCHOLOGIST
MA
01
—
4456
LICENSED PSYCHOLOGY PROVI
MA
Enumeration date
10/31/2006
Last updated
07/08/2007
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