Provider Demographics
NPI:1720861891
Name:KOCH, KATHRYN GRACE (BS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GRACE
Last Name:KOCH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8169 MORROW WOODVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PLAIN
Mailing Address - State:OH
Mailing Address - Zip Code:45162-9228
Mailing Address - Country:US
Mailing Address - Phone:859-391-0771
Mailing Address - Fax:
Practice Address - Street 1:8169 MORROW WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:PLEASANT PLAIN
Practice Address - State:OH
Practice Address - Zip Code:45162-9228
Practice Address - Country:US
Practice Address - Phone:859-391-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant