Individual
MONIKA KOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.; NCSP
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
(505) 632-4371
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
(505) 632-4371
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64434826
—
NM
05
—
74671073
—
NM
Enumeration date
08/23/2011
Last updated
03/13/2012
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