Most Relevant Information
Provider Data
| NPI Number: | 1003500638 |
| Provider Name: | ILA KOCH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/06/2023 |
| Last Updated: | 06/06/2023 |
Provider Practice Location
7760 FRANCE AVE S FL 11
MINNEAPOLIS
MN
554355930
Practice Location Phone/Fax
| Phone: | 6125948405 |
| Fax: | 8555682494 |
Provider Mailing Location
7760 FRANCE AVE S FL 11
MINNEAPOLIS
MN
554355930
Provider Mailing Phone/Fax
| Phone: | 6125948405 |
| Fax: | 8555682494 |