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Organization
CHILD AND FAMILY LEARNING
Active
Organization
CHILD AND FAMILY LEARNING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE ABBY KOCH PH.D. (OWNER/PSYCHOLOGIST)
(813) 399-1625
Entity
Organization
Contact information
Practice address
312 E 7TH AVE, TAMPA, FL 33602-2300
(813) 399-1625
Mailing address
312 E 7TH AVE, TAMPA, FL 33602-2300
(813) 399-1625
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY4230
FL
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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