Individual
MRS. HELEN BAILEY KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSP, LD
Contact information
Practice address
140 ROCKY CREEK TRL, WOODSTOCK, GA 30188-6246
(404) 543-3897
(404) 745-0808
Mailing address
140 ROCKY CREEK TRL, WOODSTOCK, GA 30188-6246
(404) 543-3897
(404) 745-0808
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD002614
GA
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
LD002614
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
922309
REGISTRATION NUMBER
GA
01
—
LD002614
STATE LICENSE
GA
Enumeration date
05/04/2007
Last updated
07/24/2022
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