Individual
LISA KOZODOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4847 BRANDEIS ST UNIT 2201, SAN ANTONIO, TX 78249-4387
(210) 440-8467
Mailing address
4847 BRANDEIS ST UNIT 2201, SAN ANTONIO, TX 78249-4387
(210) 440-8467
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT133471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT133471
LMT
TX
Enumeration date
09/13/2020
Last updated
09/13/2020
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