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NPI Code Detail

MEDICARE: ANGELA KOSKOSKY CADC

MEDICARE: ANGELA KOSKOSKY CADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor20445NC

General Provider Information

NPI Number : 1942843925
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA KOSKOSKY CADC
Provider Business Mailing Address
First Line : 3041 ROSEMEADE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28306-4228
Country : US
Telephone Number : 910-676-1635
Fax Number :
Provider Business Practice Location Address
First Line : 324 PERSON ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5736
Country : US
Telephone Number : 910-438-0939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2019
Last Update Date : 04/29/2023

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Directions to “ ANGELA KOSKOSKY CADC” Practice Location

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