Provider Demographics
NPI:1073096046
Name:COHN-AIZIC, DANIELA P
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:P
Last Name:COHN-AIZIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 ARTONDALE DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5617
Mailing Address - Country:US
Mailing Address - Phone:954-609-6341
Mailing Address - Fax:
Practice Address - Street 1:1623 E J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98421-1602
Practice Address - Country:US
Practice Address - Phone:253-779-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6556103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist