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NPI Code Detail

MEDICARE: DR. ANITA L KOZAN PHD

MEDICARE: DR. ANITA L KOZAN PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist5146MN

General Provider Information

NPI Number : 1104974732
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANITA L KOZAN PHD
Provider Business Mailing Address
First Line : 1133 RANKIN ST
Second Line : SUITE 221
City : SAINT PAUL
State : MN
Zip : 55116-3141
Country : US
Telephone Number : 651-222-7768
Fax Number : 651-698-8994
Provider Business Practice Location Address
First Line : 1133 RANKIN ST
Second Line : SUITE 221
City : SAINT PAUL
State : MN
Zip : 55116-3141
Country : US
Telephone Number : 651-222-7768
Fax Number : 651-698-8994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. ANITA L KOZAN PHD” Practice Location

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