Provider Demographics
NPI:1134307945
Name:KOSLOW, MARITZA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:KOSLOW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KARWATT CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2218
Mailing Address - Country:US
Mailing Address - Phone:732-599-6132
Mailing Address - Fax:
Practice Address - Street 1:14 KARWATT CT
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-2218
Practice Address - Country:US
Practice Address - Phone:732-599-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00364800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional