Individual
MRS. CASEY ROSE KOZLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LMFT
Contact information
Practice address
15811 AMBAUM BLVD SW STE 110, BURIEN, WA 98166-3071
(610) 739-9475
Mailing address
15811 AMBAUM BLVD SW STE 110, BURIEN, WA 98166-3071
(610) 739-9475
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MG 60501427
WA
106H00000X
Marriage & Family Therapist
Primary
LF60721682
WA
106H00000X
Marriage & Family Therapist
MG 60501427
WA
390200000X
Student in an Organized Health Care Education/Training Program
CO 60502517
WA
Other
Enumeration date
10/08/2014
Last updated
11/15/2019
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