Provider Demographics
NPI:1457365629
Name:KOZAN, ALISON BETH (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BETH
Last Name:KOZAN
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W FRONT ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2287
Mailing Address - Country:US
Mailing Address - Phone:231-935-0800
Mailing Address - Fax:231-935-0800
Practice Address - Street 1:4048 CEDAR BLUFF DR
Practice Address - Street 2:SUITE 4
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8895
Practice Address - Country:US
Practice Address - Phone:231-348-4005
Practice Address - Fax:231-348-8113
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006326225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand