Individual
JOANNE BENJAMIN KOZACHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4630 17TH ST, SARASOTA, FL 34235-1843
(941) 487-5400
(941) 487-5430
Mailing address
4630 17TH ST, SARASOTA, FL 34235-1843
(941) 487-5400
(941) 487-5430
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761017300
—
FL
Enumeration date
12/01/2006
Last updated
05/11/2012
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