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General NPI Number Information
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NPI Number | 1649341165
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Entity Type | Organization
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Legal Business Name | EVA B KOZLOVSKY MS PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2546 E FM 552
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City | ROCKWALL
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State | TX
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Zip | 75087-8384
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Country | US
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Telephone | 972-722-1919
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Fax | 972-771-1919
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Provider Business Mailing Address
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Address Line | 2546 E FM 552
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City | ROCKWALL
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State | TX
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Zip | 75087-8384
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Country | US
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Telephone | 972-722-1919
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Fax | 972-771-1919
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MS. EVA BETH KOZLOVSKY
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Credential | MS CCC SLP
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Telephone | 972-722-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 10264
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License Number State | TX
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