Individual
DR. KENNETH H BOHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8515 DELMAR BLVD, SUITE 220, SAINT LOUIS, MO 63124-2168
(314) 567-1044
(314) 567-1060
Mailing address
8515 DELMAR BLVD, SUITE 220, SAINT LOUIS, MO 63124-2168
(314) 567-1044
(314) 567-1060
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
00017
MO
103TC0700X
Clinical Psychologist
00017
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
339528
BJC BEHAVIORAL HEALTH
—
Enumeration date
09/20/2006
Last updated
09/11/2025
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