Koch, Jennifer

Koch, Jennifer is an sole proprietor health care provider with primary practice located at 3070 Rita Way Se , Smyrna GA 30080-4179. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Koch, Jennifer can be contacted via phone (770) 365-9465.

Contact Information

Primary practice address
3070 Rita Way Se Smyrna GA 30080-4179
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005448 Georgia

Profile Details

NPI number 1780614925
LBN Legal business name Koch, Jennifer
Credentials M.ED., CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Aug 13th, 2007 - about 19 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 1780614925 NPPES
Georgia MEDICAID 0977017B
Georgia MEDICAID 0977017A

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