Iryna Kozakova, LMT
Massage Therapist in Lake Mary, FL. Individual provider (NPI-1).
NPI number1205591377
StatusActive
Last updated in NPPESNov 3, 2021
Details
- NPI
- 1205591377
- Entity type
- Individual (NPI-1)
- Name
- Iryna Kozakova
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 3, 2021
- Certification date
- Nov 3, 2021
- Last updated
- Nov 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 41510 | FL | Yes |
Practice location
920 International Pkwy Ste 1040Lake Mary, FL 32746-5229
Phone 916-833-9262
Mailing address
2695 Cahill WayLake Mary, FL 32746-2321
Phone 916-833-9262
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