Provider Demographics
NPI:1578621025
Name:COUCH, VICKI L (MS)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:L
Last Name:COUCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 FOX VALLEY DR SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-3442
Mailing Address - Country:US
Mailing Address - Phone:507-280-5824
Mailing Address - Fax:
Practice Address - Street 1:MAYO CLINIC
Practice Address - Street 2:200 FIRST ST SW
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-8198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS