Individual
SAMUEL DALE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 WALL ST STE 400, MANCHESTER, NH 03101-1518
(603) 668-4111
Mailing address
2 WALL ST STE 300, MANCHESTER, NH 03101-1518
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
2706567
SC
174400000X
Specialist
—
—
Other
Enumeration date
08/14/2023
Last updated
08/05/2026
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