NPI 1710599022
Mary Koczyk, CBRS
Practice location
- Address
- 2201 N Ironwood Pl, Coeur D Alene, ID 83814-2670
- Phone
- (208) 769-4222
- Fax
- (844) 803-7399
- Mailing address
- PO Box 1387, Hayden, ID 83835-1387
Registered specialties (2)
Community Health Worker
Primary
Case Manager/Care Coordinator
Registry record
- NPI
- 1710599022
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 18 Aug 2020
- Record last updated
- 5 Oct 2020
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.