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Individual
LYNN M KOCH
Active
Individual
LYNN M KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801094798
MI
1041C0700X
Clinical Social Worker
6802085901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802085901
MICHIGAN LICENSE
MI
Enumeration date
03/26/2012
Last updated
06/17/2014
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