Organization
GLENN R. KOCH & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN ROBERT KOCH I M.A. (LICENSED PSYCHOLOGIST)
(610) 266-0610
Entity
Organization
Contact information
Practice address
961 MARCON BLVD STE 312, ALLENTOWN, PA 18109-9373
(610) 266-0610
(610) 266-0292
Mailing address
961 MARCON BLVD STE 312, ALLENTOWN, PA 18109-9373
(610) 266-0610
(610) 266-0292
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS005286-L
PA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016509210002
—
PA
05
—
1029487670001
—
PA
Enumeration date
07/15/2014
Last updated
04/08/2024
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