Provider Demographics
NPI:1740591361
Name:KOCH, ADRIANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:
Last Name:KOCH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ADRIANE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4870 E KANSAS DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3213
Mailing Address - Country:US
Mailing Address - Phone:303-910-6327
Mailing Address - Fax:
Practice Address - Street 1:6535 S DAYTON ST STE 3800
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-6181
Practice Address - Country:US
Practice Address - Phone:303-910-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12147682235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist