Provider Demographics
NPI:1356738439
Name:KOHLI, KIMBERLY IRENE (PHD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:IRENE
Last Name:KOHLI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6457 REFLECTIONS DR
Mailing Address - Street 2:STE 120
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2352
Mailing Address - Country:US
Mailing Address - Phone:614-354-1730
Mailing Address - Fax:
Practice Address - Street 1:1580 STATE ROUTE 56
Practice Address - Street 2:MADISON CORRECTIONAL INSTITUTION
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140
Practice Address - Country:US
Practice Address - Phone:740-852-9777
Practice Address - Fax:740-852-3666
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH7227103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist