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KIRBY COSCO MA CCC SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1730665324

Individual Registrant:
 KIRBY  COSCO MA CCC SLP
Gender: F
Sole Proprietor

Location and contact information for practice:
193 SAM LISENBY RD  OZARK, AL 36360-3048 US
Tel: 334-445-6336  Fax: --

Contact information for business:
193 SAM LISENBY RD  OZARK, AL 36360-3048 US
Tel: --  Fax: --

Registration Information:
NPI: 1730665324
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
TRICARE000001




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