Doctor Name: | DEBORAH KOZISEK |
NPI Number: | 1902174691 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1989 |
Business Practice Address: | 13 Water St Danielson, CT - 062392838 |
Business Phone Number: | 8607795882 |
Business Fax Number: | 8607795000 |
Mailing Address: | 13 Water St, DANIELSON |
State: | CT |
Postal Code: | 062392838 |
Phone Number: | 8607795882 |
Fax Number: | 8607795000 |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 12/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1989 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |