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NPI Code Detail

MEDICARE: CASSIDY LEIGH KOZIOL OTR

MEDICARE: CASSIDY LEIGH KOZIOL OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1588244271
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIDY LEIGH KOZIOL OTR
Provider Business Mailing Address
First Line : 6975 E PRINCESS DR APT 1043
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-4211
Country : US
Telephone Number : 603-651-3164
Fax Number :
Provider Business Practice Location Address
First Line : 6975 E PRINCESS DR APT 1043
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-4211
Country : US
Telephone Number : 603-651-3164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2021
Last Update Date : 04/08/2021

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Directions to “ CASSIDY LEIGH KOZIOL OTR” Practice Location

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