Individual
MS. SANDRA RAE KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
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
11/01/2006
Last updated
07/08/2007
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