Provider Demographics
NPI:1508998964
Name:KOSZEGI, ARON O'BRIEN (MA, LLP)
Entity Type:Individual
Prefix:
First Name:ARON
Middle Name:O'BRIEN
Last Name:KOSZEGI
Suffix:
Gender:M
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4281
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-4281
Mailing Address - Country:US
Mailing Address - Phone:517-745-3186
Mailing Address - Fax:
Practice Address - Street 1:432 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1148
Practice Address - Country:US
Practice Address - Phone:517-745-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012086103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical