Provider Demographics
NPI:1134820038
Name:COZINO, BRIANNA MARIE
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:COZINO
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 1:104 S FREYA ST STE 212
Mailing Address - Street 2:GREEN BLD
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4871
Mailing Address - Country:US
Mailing Address - Phone:509-869-9457
Mailing Address - Fax:
Practice Address - Street 1:104 S FREYA ST STE 212
Practice Address - Street 2:GREEN BLD
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4871
Practice Address - Country:US
Practice Address - Phone:509-869-9457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61407176101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)