Provider Demographics
NPI:1174234348
Name:KOCHMAN, DREW
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:KOCHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RIOTT
Other - Middle Name:
Other - Last Name:KOCHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5119 JAMIESON AVE # A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 S KINGSHIGHWAY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1003
Practice Address - Country:US
Practice Address - Phone:314-296-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker