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NPI Code Detail

MEDICARE: KATHRYN GRACE KOCH BS

MEDICARE:   KATHRYN GRACE KOCH  BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant

General Provider Information

NPI Number : 1720861891
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN GRACE KOCH BS
Provider Business Mailing Address
First Line : 8169 MORROW WOODVILLE RD
Second Line :
City : PLEASANT PLAIN
State : OH
Zip : 45162-9228
Country : US
Telephone Number : 859-391-0771
Fax Number :
Provider Business Practice Location Address
First Line : 8169 MORROW WOODVILLE RD
Second Line :
City : PLEASANT PLAIN
State : OH
Zip : 45162-9228
Country : US
Telephone Number : 859-391-0771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ KATHRYN GRACE KOCH BS” Practice Location

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