Provider Demographics
NPI:1538826409
Name:COGSIL, GALADRIEL
Entity type:Individual
Prefix:
First Name:GALADRIEL
Middle Name:
Last Name:COGSIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GALADRIEL
Other - Middle Name:
Other - Last Name:MONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1867 ARBORDALE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4541
Mailing Address - Country:US
Mailing Address - Phone:330-277-6615
Mailing Address - Fax:
Practice Address - Street 1:1867 ARBORDALE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4541
Practice Address - Country:US
Practice Address - Phone:330-277-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-26
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty