Provider Demographics
NPI:1639542996
Name:COSEY, GABRE (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:GABRE
Middle Name:
Last Name:COSEY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LAKE COVE LN
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5352
Mailing Address - Country:US
Mailing Address - Phone:302-233-0658
Mailing Address - Fax:
Practice Address - Street 1:914 N DUPONT BLVD STE C
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1044
Practice Address - Country:US
Practice Address - Phone:302-422-6670
Practice Address - Fax:302-422-5660
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00007052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer