Organization
ALIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN KOSICEK PMHNP-BC (OWNER)
(520) 771-0555
Entity
Organization
Contact information
Practice address
699 WALNUT ST STE 10, DES MOINES, IA 50309-3929
(515) 416-8830
(262) 260-9109
Mailing address
7426 N LA CHOLLA BLVD, TUCSON, AZ 85741-2306
(520) 771-0555
(262) 260-9109
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
12/07/2022
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