Individual
JUDITH ANN KOSKODAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007048
MI
235Z00000X
Speech-Language Pathologist
5501007048
MI
Other
Enumeration date
12/16/2008
Last updated
08/26/2021
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