Most Relevant Information
Provider Data
| NPI Number: | 1003694530 |
| Provider Name: | AMANDA R KOCH RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2023 |
| Last Updated: | 09/18/2023 |
Provider Practice Location
4015 CRESCENT PARK DR
RIVERVIEW
FL
335783605
Practice Location Phone/Fax
| Phone: | 8134928310 |
| Fax: |
Provider Mailing Location
4015 CRESCENT PARK DR
RIVERVIEW
FL
335783605
Provider Mailing Phone/Fax
| Phone: | 8134928310 |
| Fax: |