Individual
MARY JO KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 S MARSHALL ST, BOONE, IA 50036-4899
(515) 432-7983
Mailing address
125 S 3RD ST, AMES, IA 50010-7042
(515) 233-2250
(515) 233-3235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
088801
IA
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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