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Individual

EMMIE MACKENZIE COSTEN TOZIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CF-SLP

Contact information

Practice address
1520 GLENWOOD AVE STE 201, RALEIGH, NC 27608-2264
(919) 577-6807
Mailing address
141 N MAIN ST, FUQUAY VARINA, NC 27526-1933
(919) 577-6807

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22032113
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22032113
TEMPORARY NC SLP LICENSE
NC
Enumeration date
06/28/2021
Last updated
06/28/2021
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