| NPI | 1013146638 |
|---|---|
| Former Name | FAWN M KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2010-03-04 |