Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201003832 | MI |
N | 225XE0001X | Environmental Modification | ||
N | 225XE0001X | Environmental Modification | 5201003832 | MI |
N | 225XF0002X | Feeding, Eating & Swallowing | 5201003832 | MI |
N | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XG0600X | Occupational Therapist - Gerontology | 5201003832 | MI |
N | 225XL0004X | Low Vision | ||
N | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1003965468 |
---|---|
Provider Name | Karen Kelly Koch |
First Address | Coloma, MI 49038-9117 |
Second Address | Coloma, MI 49038-9117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 17/05/2020 |