| NPI | 1093122699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ROBERT KOCH Licensed Psychologist 610-266-0610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PA Ps005286-L) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2024-04-08 |