| Doctor Name: | MICHELLE KOCH |
| NPI Number: | 1295088763 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 37PC00447600 |
| Business Practice Address: | 2329 Highway 34 Suite 101 Manasquan, NJ - 087361442 |
| Business Phone Number: | 7322239355 |
| Business Fax Number: | 7322239350 |
| Mailing Address: | 2329 Highway 34, Suite 101 MANASQUAN |
| State: | NJ |
| Postal Code: | 087361442 |
| Phone Number: | 7322239355 |
| Fax Number: | 7322239350 |
| NPI Enumeration Date: | 10/22/2012 |
| NPI Last Update Date: | 10/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 37PC00447600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |