Organization
ISLES THERAPY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA R KOCH MA, LP (LICENSED PSYCHOLOGIST)
(612) 823-2063
Entity
Organization
Contact information
Practice address
615 W 35TH ST, MINNEAPOLIS, MN 55408-4602
(612) 823-2063
(612) 823-8438
Mailing address
615 W 35TH ST, MINNEAPOLIS, MN 55408-4602
(612) 823-2063
(612) 823-8438
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3420
MN
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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