Provider Demographics
NPI:1538377841
Name:KOSINSKI, JUDI DEBORAH (MA)
Entity type:Individual
Prefix:MS
First Name:JUDI
Middle Name:DEBORAH
Last Name:KOSINSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JUDI
Other - Middle Name:DEBORAH
Other - Last Name:HAVAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:6481 MEADOW HILL DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6308
Mailing Address - Country:US
Mailing Address - Phone:775-826-8119
Mailing Address - Fax:775-826-6639
Practice Address - Street 1:6481 MEADOW HILL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6308
Practice Address - Country:US
Practice Address - Phone:775-826-8119
Practice Address - Fax:775-826-6639
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV003106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist