Individual
BROOKE KOSIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
112 1ST ST NE, ASHLEY, ND 58413-0218
(701) 288-3343
(701) 288-2186
Mailing address
PO BOX 218, ASHLEY, ND 58413-0218
(701) 288-3343
(701) 288-2186
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00000
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50736
—
ND
Enumeration date
01/20/2015
Last updated
01/20/2015
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