Koch, Michael P

Koch, Michael P is an individual health care provider with primary practice located at 8611 W Point Douglas Rd S , Cottage Grove MN 55016-4005. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Koch, Michael P can be contacted via phone (651) 458-1884.

Contact Information

Primary practice address
8611 W Point Douglas Rd S Cottage Grove MN 55016-4005
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 5141 Minnesota

Profile Details

NPI number 1861453714
LBN Legal business name Koch, Michael P
Credentials LIC SW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Jan 12th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861453714 NPPES
Minnesota MEDICAID 768170400

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