Doctor Name: | PATRICK HILARY KOZLOWSKI |
NPI Number: | 1164862439 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 6401010200 |
Business Practice Address: | 2198 Us 31 S Manistee, MI - 496609618 |
Business Phone Number: | 8773982013 |
Business Fax Number: | 2317231735 |
Mailing Address: | 2198 Us 31 S, MANISTEE |
State: | MI |
Postal Code: | 496609618 |
Phone Number: | 8773982013 |
Fax Number: | 2317231735 |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 07/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401010200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |