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Individual

MRS. JESSICA ANN KOZAREVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
(580) 762-2576
Mailing address
4601 S UNION ST, PONCA CITY, OK 74601-7612
(580) 765-0772

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3567
OK

Other

Enumeration date
07/12/2010
Last updated
07/12/2010
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