Koczyk, Mary

Koczyk, Mary is an individual health care provider with primary practice located at 2201 N Ironwood Pl , Coeur D Alene ID 83814-2670. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Koczyk, Mary can be contacted via phone (208) 769-4222.

Contact Information

Primary practice address
2201 N Ironwood Pl Coeur D Alene ID 83814-2670
Phone: (208) 769-4222
Fax: (844) 803-7399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1710599022
LBN Legal business name Koczyk, Mary
Credentials CBRS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2020
Last updated Oct 5th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710599022 NPPES
Idaho Other CD2576341 DRIVERS LICENSE

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