| NPI | 1912041138 |
|---|---|
| Former Name | BRIAN KEITH COSBY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2011-02-03 |