Provider Demographics
NPI:1891339636
Name:KOU, SIO NGA (CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SIO NGA
Middle Name:
Last Name:KOU
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 BRAINERD RD APT 7
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3721
Mailing Address - Country:US
Mailing Address - Phone:513-593-4916
Mailing Address - Fax:
Practice Address - Street 1:115 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4422
Practice Address - Country:US
Practice Address - Phone:401-444-9256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist