Individual
MRS. ASHLEY RENE KOSSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
93 CAMPUS AVE, LEWISTON, ME 04240-6030
(518) 744-7527
Mailing address
48 RUBY LANE, DURHAM, ME 04222
(518) 744-7527
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
15070
OR
235Z00000X
Speech-Language Pathologist
Primary
SP3547
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500619294
—
OR
Enumeration date
06/19/2013
Last updated
11/01/2021
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