Provider Demographics
NPI:1164219143
Name:KOZA, CINDY (QMHA-R)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:KOZA
Suffix:
Gender:F
Credentials:QMHA-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-5369
Mailing Address - Country:US
Mailing Address - Phone:541-654-1769
Mailing Address - Fax:541-654-1769
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-5369
Practice Address - Country:US
Practice Address - Phone:541-654-1769
Practice Address - Fax:541-654-1769
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health