Healthcare Provider Details
I. General information
NPI: 1205291358
Provider Name (Legal Business Name): JESSICA ELLEN KOZAR OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/16/2015
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
483 FRYE FARM RD
GREENSBURG PA
15601-6480
US
IV. Provider business mailing address
483 FRYE FARM RD
GREENSBURG PA
15601-6480
US
V. Phone/Fax
- Phone: 724-804-5621
- Fax: 412-804-5615
- Phone: 724-804-5621
- Fax: 412-804-5615
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OC014032 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: