Individual
REBECCA KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
8118 GOOD LUCK RD, LANHAM, MD 20706-3574
(301) 552-8166
Mailing address
10011 GREENBELT RD, APT 301, LANHAM, MD 20706-2232
(610) 653-4372
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DX3368
MD
133V00000X
Registered Dietitian
Primary
1064795
PA
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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