Provider Demographics
NPI:1487780938
Name:COHEN, CHRISTINA HANSEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:HANSEN
Last Name:COHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 VERONICA SHOEMAKER BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916
Mailing Address - Country:US
Mailing Address - Phone:239-274-7792
Mailing Address - Fax:239-247-5344
Practice Address - Street 1:4301 VERONICA S SHOEMAKER BLVD STE B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-2216
Practice Address - Country:US
Practice Address - Phone:239-274-7792
Practice Address - Fax:239-247-5344
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7935103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical