Individual
DR. S GRAHAM KOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
100 S PONCE DE LEON BLVD, SUITE 1, ST AUGUSTINE, FL 32084-4214
(904) 824-7733
Mailing address
100 S PONCE DE LEON BLVD, SUITE 1, ST AUGUSTINE, FL 32084-4214
(904) 824-7733
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY2354
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254757100
—
FL
Enumeration date
07/18/2006
Last updated
03/24/2017
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