Individual
MISS SHELBY KRISTINE KOCH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3231 41ST AVE SW APT 1, SEATTLE, WA 98116-3400
(425) 984-4041
Mailing address
14915 38TH DR SE UNIT S1148, BOTHELL, WA 98012-4227
(425) 984-4041
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61176953
WA
106E00000X
Assistant Behavior Analyst
AB1035097
WA
Other
Enumeration date
04/19/2021
Last updated
09/24/2021
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