Provider Demographics
NPI:1053514562
Name:KOHLBUS, CARIN MARIE
Entity type:Individual
Prefix:
First Name:CARIN
Middle Name:MARIE
Last Name:KOHLBUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CARIN
Other - Middle Name:MARIE
Other - Last Name:CUSMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:1780 KENDARBREN DRIVE
Mailing Address - Street 2:INVO HEALTH CARE ASSOCIATES
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929
Mailing Address - Country:US
Mailing Address - Phone:215-489-8760
Mailing Address - Fax:215-489-8766
Practice Address - Street 1:1780 KENDARBREN DRIVE
Practice Address - Street 2:INVO HEALTH CARE ASSOCIATES
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929
Practice Address - Country:US
Practice Address - Phone:215-489-8760
Practice Address - Fax:215-489-8766
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001409L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017343420007OtherMA NUMBER