Provider Demographics
NPI:1821143488
Name:KOSLOW, ABIGAIL R (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:R
Last Name:KOSLOW
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:R
Other - Last Name:EDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2623 S SEACREST BLVD
Mailing Address - Street 2:LOWER LEVEL SUITE 10
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7501
Mailing Address - Country:US
Mailing Address - Phone:561-737-7733
Mailing Address - Fax:561-735-7036
Practice Address - Street 1:2623 S SEACREST BLVD
Practice Address - Street 2:LOWER LEVEL SUITE 10
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7501
Practice Address - Country:US
Practice Address - Phone:561-737-7733
Practice Address - Fax:561-735-7036
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6754235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist