Individual
MARY ELIZABETH KOSIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R05570640
MN
Other
Enumeration date
04/25/2006
Last updated
03/25/2009
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