Individual
MRS. ALICIA JANETTE KOSTOV
Active
Individual
MRS. ALICIA JANETTE KOSTOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
113613
MA
1041C0700X
Clinical Social Worker
51367
TX
1041C0700X
Clinical Social Worker
Primary
LCSW-15849
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051YP
BLUE CROSS
TX
05
—
162516
—
AZ
05
—
613430
—
TX
Enumeration date
08/14/2006
Last updated
04/23/2017
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