Provider Demographics
NPI:1528084597
Name:KOSOY, MARJORIE A (ED D, PC)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:A
Last Name:KOSOY
Suffix:
Gender:F
Credentials:ED D, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 WEST LOOP S
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2900
Mailing Address - Country:US
Mailing Address - Phone:713-621-2700
Mailing Address - Fax:713-839-7644
Practice Address - Street 1:6300 WEST LOOP S
Practice Address - Street 2:SUITE 240
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2900
Practice Address - Country:US
Practice Address - Phone:713-621-2700
Practice Address - Fax:713-839-7644
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22131103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist