Individual
MRS. CARRIE A. KOZAK-HIETALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.2405256
OH
104100000X
Social Worker
S0800557
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256889
—
OH
Enumeration date
05/31/2017
Last updated
04/12/2024
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