Individual
MICHELLE L KOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
97 GREAT TEAYS BLVD, SUITE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 201-5019
Mailing address
97 GREAT TEAYS BLVD, SUITE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00941890
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194170191
—
WV
Enumeration date
04/27/2016
Last updated
08/02/2019
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