Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003146838 |
---|---|
Provider Name | Ms. Margaret Elizabeth Koch |
First Address | Wakefield, RI 02879-8120 |
Second Address | Middletown, RI 02842-5641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2009 |
Last Update Date | 06/01/2011 |