Individual
DR. HENRY THOMAS KOCH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-2894
(703) 330-9933
(703) 368-8454
Mailing address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-2894
(703) 330-9933
(703) 368-8454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0810001860
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7705981
—
VA
Enumeration date
07/12/2006
Last updated
11/14/2007
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