Individual
KAYLAN KOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
635 MAIN ST, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 704-8034
Mailing address
635 MAIN ST, ATTN CREDENTIALING DEPARTMENT, MIDDLETOWN, CT 06457-2718
(860) 347-6971
(860) 638-6601
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
007079
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236338
—
CT
Enumeration date
02/21/2007
Last updated
07/28/2009
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