Individual
MRS. KOSHA GIBBS ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
301 DOVE RIDGE RD, COLUMBIA, SC 29223-5593
(803) 699-6169
Mailing address
301 DOVE RIDGE RD, COLUMBIA, SC 29223-5593
(803) 699-6169
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3613
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0656
—
SC
Enumeration date
07/07/2006
Last updated
07/09/2007
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