| NPI | 1619191574 |
|---|---|
| Former Name | MARYELLEN C. KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2018037916) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: MO 2000148952) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2023-10-18 |