MEDICARE: ANDREA TALUC COZBY FLPC

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
1	101YP2500X	Professional Counselor	19048	TX

General Provider Information

NPI Number	:	1508685496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA TALUC COZBY FLPC

Provider Business Mailing Address
First Line	:	3421 GRANADA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2233
Country	:	US
Telephone Number	:	214-912-4872
Fax Number	:

Provider Business Practice Location Address
First Line	:	3421 GRANADA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2233
Country	:	US
Telephone Number	:	214-912-4872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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Directions to “ ANDREA TALUC COZBY FLPC” Practice Location

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