Most Relevant Information
Provider Data
| NPI Number: | 1003463001 |
| Provider Name: | AMELIA RAE KOETHEN MHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | P101516 |
Most Important Dates
| Enumeration Date: | 08/23/2019 |
| Last Updated: | 08/23/2019 |
Provider Practice Location
391 MYRTLE AVE STE 3A
ALBANY
NY
122083797
Practice Location Phone/Fax
| Phone: | 5182622700 |
| Fax: |
Provider Mailing Location
391 MYRTLE AVE STE 3A
ALBANY
NY
122083797
Provider Mailing Phone/Fax
| Phone: | 5182622700 |
| Fax: |