Individual
DR. A ELIZABETH KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2486 PASS RD, BILOXI, MS 39531-2838
(228) 388-6006
(228) 388-6027
Mailing address
2486 PASS RD, BILOXI, MS 39531-2838
(228) 388-6006
(228) 388-6027
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
47 823
MS
103TC0700X
Clinical Psychologist
522
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521901
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/20/2006
Last updated
11/17/2009
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