Healthcare Provider Details

I. General information

NPI: 1518105675
Provider Name (Legal Business Name): KATIE MICHELE KOCHER MA, PCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 W STATE ST STE G
ALLIANCE OH
44601-4686
US

IV. Provider business mailing address

PO BOX 742
MALVERN OH
44644-0742
US

V. Phone/Fax

Practice location:
  • Phone: 330-823-5335
  • Fax:
Mailing address:
  • Phone: 330-936-4238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC0701192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: