| Glenn R. Koch & Associates, Llc | |
|
961 Marcon Blvd Ste 312 Allentown PA 18109-9373 | |
| (610) 266-0610 | |
| (610) 266-0292 |
| Full Name | Glenn R. Koch & Associates, Llc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 961 Marcon Blvd Ste 312, Allentown, Pennsylvania |
| Authorized Official Name and Position | Glenn Robert Koch (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6102660610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn R. Koch & Associates, Llc 961 Marcon Blvd Ste 312 Allentown PA 18109-9373 Ph: (610) 266-0610 | Glenn R. Koch & Associates, Llc 961 Marcon Blvd Ste 312 Allentown PA 18109-9373 Ph: (610) 266-0610 |
| NPI Number | 1093122699 |
|---|---|
| Provider Enumeration Date | 07/15/2014 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093122699 | NPI | - | NPPES |
| 1029487670001 | Medicaid | PA | |
| 0016509210002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PS005286-L (Pennsylvania) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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