Provider Demographics
NPI:1215481387
Name:ERIN L. KOCH AND ASSOCIATES
Entity type:Organization
Organization Name:ERIN L. KOCH AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SLP
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:301-476-0174
Mailing Address - Street 1:17320 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-9530
Mailing Address - Country:US
Mailing Address - Phone:307-476-0174
Mailing Address - Fax:301-710-0604
Practice Address - Street 1:17320 MOORE RD
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841-9530
Practice Address - Country:US
Practice Address - Phone:307-476-0174
Practice Address - Fax:301-710-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty