Individual
STACEY KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 RAILROAD ST STE 406, ELKO, NV 89801-3727
(775) 389-2700
Mailing address
PO BOX 2222, ELKO, NV 89803-2222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
33002
CA
1041C0700X
Clinical Social Worker
Primary
8206-C
NV
1041C0700X
Clinical Social Worker
86299
CA
Other
Enumeration date
12/10/2010
Last updated
02/24/2020
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