Provider Demographics
NPI:1104463132
Name:KOZEGAH, JOYCE ASANTEWAA
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ASANTEWAA
Last Name:KOZEGAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 S GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5549
Mailing Address - Country:US
Mailing Address - Phone:614-224-2988
Mailing Address - Fax:614-716-0902
Practice Address - Street 1:3349 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1957
Practice Address - Country:US
Practice Address - Phone:614-235-4426
Practice Address - Fax:614-716-0902
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator