Provider Demographics
NPI:1003950916
Name:GOSU, UMA KALANI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:UMA
Middle Name:KALANI
Last Name:GOSU
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S SHARON AMITY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3871
Mailing Address - Country:US
Mailing Address - Phone:704-944-4283
Mailing Address - Fax:980-819-7817
Practice Address - Street 1:135 S SHARON AMITY RD STE 208
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-944-4283
Practice Address - Fax:980-819-7817
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE010000899235500000X
PASL007938235Z00000X
NC12093235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist