Doctor Name: | MARY KOZAK |
NPI Number: | 1720401862 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | SP4957 |
Business Practice Address: | 3260 Oxford Millvl Rd Oxford, OH - 450569430 |
Business Phone Number: | 5132733633 |
Business Fax Number: | |
Mailing Address: | 784 Woods Rd, RICHMOND |
State: | IN |
Postal Code: | 473749409 |
Phone Number: | 7659622349 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2014 |
NPI Last Update Date: | 01/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP4957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |