Individual
MS. JENNETTE MARIE COSOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCCSLP
Contact information
Practice address
401 SOUTH QUEEN STREET, MARTINSBURG, WV 25401
(304) 267-3500
(304) 267-3599
Mailing address
300 YALE DR, WINCHESTER, VA 22602
(540) 722-4465
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
324
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154440600
—
WV
Enumeration date
01/23/2008
Last updated
01/23/2008
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