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General NPI Number Information
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NPI Number | 1346594546
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Entity Type | Individual
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Provider Name | JULIE KOCH PH.D., LHSP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 418 WILLARD HALL
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City | STILLWATER
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State | OK
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Zip | 74078-1001
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Country | US
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Telephone | 405-744-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 219 E ROGERS DR
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City | STILLWATER
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State | OK
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Zip | 74075-1623
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1133
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License Number State | OK
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