Individual
AMANDA ANN KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
210 5TH AVE NE APT 204, SAINT CLOUD, MN 56304-0475
(320) 360-6004
Mailing address
210 5TH AVE NE APT 204, SAINT CLOUD, MN 56304-0475
(320) 360-6004
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
MN
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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