NPI 1417165119

Ireneus Jerome Kozak, ATR

Practitioner Art Therapist Warren, MI

Practice location

Address: 28494 Walker Ave, Warren, MI 48092-2543
Phone: (734) 657-2237

Registered specialties

Art Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 221700000X

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Registry record

NPI: 1417165119
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.