Provider Demographics
NPI:1194919498
Name:KOEHN, MARIA B (LMFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:B
Last Name:KOEHN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 SUNCAST LN STE 7
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9326
Mailing Address - Country:US
Mailing Address - Phone:916-541-2681
Mailing Address - Fax:
Practice Address - Street 1:1158 SUNCAST LN STE 7
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9326
Practice Address - Country:US
Practice Address - Phone:916-541-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist