Provider Demographics
NPI:1902116536
Name:KOZIKOWSKI, KATHERINE (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KOZIKOWSKI
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:MA
Mailing Address - Zip Code:01071-9658
Mailing Address - Country:US
Mailing Address - Phone:413-454-8135
Mailing Address - Fax:
Practice Address - Street 1:1111 ELM ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1540
Practice Address - Country:US
Practice Address - Phone:413-734-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-17
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst