Provider Demographics
NPI:1437646726
Name:KOSCH, BRIANNE A (CCC-SLP/ATP)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:A
Last Name:KOSCH
Suffix:
Gender:F
Credentials:CCC-SLP/ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STRAWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03290-4935
Mailing Address - Country:US
Mailing Address - Phone:908-477-4344
Mailing Address - Fax:
Practice Address - Street 1:6 STRAWBERRY LN
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03290-4935
Practice Address - Country:US
Practice Address - Phone:908-477-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021737-1OtherNY SPEECH-LANGUAGE PATHOLOGY LICENSE
VA2202008838OtherVA SPEECH-LANGUAGE PATHOLOGY LICENSE
12107887OtherASHA
NJ41YS00685200OtherNJ SPEECH-LANGUAGE PATHOLOGY LICENSE
1770OtherNH SPEECH-LANGUAGE PATHOLOGY LICENSE