Provider Demographics
NPI:1992862023
Name:COZZI, STEPHANIE ROLLS (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ROLLS
Last Name:COZZI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FAIRVIEW RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2334
Mailing Address - Country:US
Mailing Address - Phone:610-544-9038
Mailing Address - Fax:610-461-8388
Practice Address - Street 1:630 FAIRVIEW RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2334
Practice Address - Country:US
Practice Address - Phone:610-544-9038
Practice Address - Fax:610-461-8388
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006241L103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7611126OtherAETNA
PA2128974000OtherAMERIHEALTH
PA0001445441OtherBLUE CROSS BLUE SHIELD
PA28417000OtherMAGELLAN HEALTH CARE