Individual
MRS. MARY KAY KOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
19401 HUBBARD DR, DEARBORN, MI 48126-2641
(313) 982-8192
(313) 982-8493
Mailing address
9027 ROBINDALE, REDFORD, MI 48239-1578
(313) 531-1307
(313) 982-8493
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R416222
MI
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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