Individual
MS. CHARLENE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
235 BLUE POINT AVE, BLUE POINT, NY 11715-1261
(631) 363-5794
Mailing address
235 BLUE POINT AVE, BLUE POINT, NY 11715-1261
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008506-1
NY
Other
Enumeration date
09/09/2014
Last updated
07/05/2023
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