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Individual

MISS PATRICIA E KOSTOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1823 SUNSET PL STE C, LONGMONT, CO 80501-6544
(720) 771-5800
Mailing address
1823 SUNSET PL STE C, LONGMONT, CO 80501-6544
(720) 771-5800

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44403
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
CO
Enumeration date
03/22/2018
Last updated
01/24/2024
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