Individual
MARK G KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1011 N. MAIN ST. #21, WHITE RIVER JUNCTION, VT 05001
(802) 299-1192
Mailing address
PO BOX 187, HARTLAND, VT 05048-9427
(802) 299-1192
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
100-0000053
VT
106H00000X
Marriage & Family Therapist
1999139249
MO
Other
Enumeration date
12/07/2006
Last updated
02/16/2011
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