Individual
CHRISTOPHER MICHAEL KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12015 W DICKENS DR, BOISE, ID 83709-7737
(208) 972-0852
Mailing address
12015 W DICKENS DR, BOISE, ID 83709-7737
(208) 972-0852
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-30865
ID
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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