Provider Demographics
NPI:1124547906
Name:COCOZZA, KYLIE JOANNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:JOANNE
Last Name:COCOZZA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:JOANNE
Other - Last Name:ZURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:390 ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02650-1154
Mailing Address - Country:US
Mailing Address - Phone:774-209-9143
Mailing Address - Fax:
Practice Address - Street 1:390 ORLEANS RD
Practice Address - Street 2:
Practice Address - City:NORTH CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02650-1154
Practice Address - Country:US
Practice Address - Phone:508-945-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76653235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist