Provider Demographics
NPI:1184136194
Name:COZART, AMANDA (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:COZART
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:TKACHUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:13218 W JEWELL PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4222
Mailing Address - Country:US
Mailing Address - Phone:303-425-8191
Mailing Address - Fax:303-425-8171
Practice Address - Street 1:3550 LUTHERAN PKWY STE 105
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6025
Practice Address - Country:US
Practice Address - Phone:303-425-8191
Practice Address - Fax:303-425-8171
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS