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General NPI Number Information
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NPI Number | 1528093945
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Entity Type | Individual
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Provider Name | COZETTA LAMORE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 227 COUNTY ROAD 168 W
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City | KILGORE
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State | TX
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Zip | 75662-0903
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Country | US
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Telephone | 903-988-8275
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Fax |
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Provider Business Mailing Address
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Address Line | 6144 GATEWAY CTR #136
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City | KILGORE
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State | TX
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Zip | 75662-2255
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Country | US
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Telephone | 903-988-8275
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Fax | 501-629-8566
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20289
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License Number State | TX
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