Provider Demographics
NPI:1053482455
Name:COZORT, DONNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:COZORT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:COZART
Other - Last Name:FUESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8215 WESTCHESTER DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-891-0925
Mailing Address - Fax:214-891-1710
Practice Address - Street 1:8215 WESTCHESTER DR
Practice Address - Street 2:SUITE 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225
Practice Address - Country:US
Practice Address - Phone:214-891-0925
Practice Address - Fax:214-891-1710
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D29BMedicare ID - Type Unspecified