Individual
MRS. LEANN GAYLE KOZELISKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10251 N 35TH AVE, PHOENIX, AZ 85051-1305
(602) 995-7366
Mailing address
23801 N 35TH DR, GLENDALE, AZ 85310-4169
(623) 580-8526
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3257
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051728
COTA CERT.
AZ
Enumeration date
10/27/2006
Last updated
07/08/2007
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