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Individual

THOMAS EDWARD KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
803 3RD AVE # IA51501, COUNCIL BLUFFS, IA 51501-4101
(712) 352-0917
(712) 352-0837
Mailing address
4916 WEBSTER ST, OMAHA, NE 68132-2426
(310) 717-0404

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
096742
IA
101YM0800X
Mental Health Counselor
11982
NE

Other

Enumeration date
09/19/2019
Last updated
09/19/2019
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