Provider Demographics
NPI:1588088793
Name:KOCH, SARAH LEE
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LEE
Last Name:KOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:LEE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5954 LONGFORD RD
Mailing Address - Street 2:HUBER HTS CITY SCHOOLS
Mailing Address - City:HUBER HTS.
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2699
Mailing Address - Country:US
Mailing Address - Phone:937-237-6308
Mailing Address - Fax:
Practice Address - Street 1:5954 LONGFORD RD
Practice Address - Street 2:HUBER HTS CITY SCHOOLS
Practice Address - City:HUBER HTS.
Practice Address - State:OH
Practice Address - Zip Code:45424-2699
Practice Address - Country:US
Practice Address - Phone:937-237-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2896235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist