Provider Demographics
NPI:1730249889
Name:KOEHLER, JEAN DUNMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:DUNMAN
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 SYCAMORE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6293
Mailing Address - Country:US
Mailing Address - Phone:502-429-6311
Mailing Address - Fax:
Practice Address - Street 1:6000 BROWNSBORO PARK BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-7201
Practice Address - Country:US
Practice Address - Phone:502-897-2717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist