Provider Demographics
NPI:1356917538
Name:COZINE, HANNA NICOLE
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:NICOLE
Last Name:COZINE
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 1:12525 N LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8450
Mailing Address - Country:US
Mailing Address - Phone:317-750-6919
Mailing Address - Fax:
Practice Address - Street 1:12525 N LOUIS DR
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8450
Practice Address - Country:US
Practice Address - Phone:317-750-6919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)