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General NPI Number Information
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NPI Number | 1841655529
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Entity Type | Individual
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Provider Name | LAURA KOZIEJ MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 720 ROOSEVELT RD
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City | GLEN ELLYN
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State | IL
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Zip | 60137-5806
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Country | US
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Telephone | 163-098-4220
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Fax | 630-984-2051
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Provider Business Mailing Address
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Address Line | 4550 N LAPORTE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3916
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Country | US
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Telephone |
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178011595
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License Number State | IL
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