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General NPI Number Information
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NPI Number | 1891210100
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Entity Type | Individual
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Provider Name | DANIELLA KOZAN MA
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 12835 MEEHAN DR
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City | AUSTIN
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State | TX
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Zip | 78727-4518
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Country | US
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Telephone | 646-701-3514
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Fax |
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Provider Business Mailing Address
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Address Line | 12835 MEEHAN DR
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City | AUSTIN
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State | TX
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Zip | 78727-4518
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Country | US
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Telephone | 646-701-3514
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 18335
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 83268
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License Number State | TX
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