Provider Demographics
NPI:1710323951
Name:KOTOSKI, MEREDITH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:KOTOSKI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 WESTMORELAND ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1768
Mailing Address - Country:US
Mailing Address - Phone:703-237-4550
Mailing Address - Fax:703-237-4880
Practice Address - Street 1:2030 WESTMORELAND ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-1768
Practice Address - Country:US
Practice Address - Phone:703-237-4550
Practice Address - Fax:703-237-4880
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07167235Z00000X
VA2202006182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist