Provider Information for 1356081533
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JESSIE KOZMOSKI LCSW
Sex: Female
NPI: 1356081533
Last Updated: 2022-03-29
Certification Date: 2022-03-29
Certification Date: 2022-03-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1356081533 | ||||||||
| Enumeration Date | 2022-03-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2 VILLAGE WAY UNIT 1 VERNON, NJ 07462-3113 United States Phone: 973-219-3593 | Fax: | ||||||||
| Primary Practice Address | 2 VILLAGE WAY UNIT 1 VERNON, NJ 07462-3113 United States Phone: 973-219-3593 | Fax: | ||||||||
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