Provider Demographics
NPI:1881079085
Name:COSAND, KYLENE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KYLENE
Middle Name:
Last Name:COSAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KYLENE
Other - Middle Name:
Other - Last Name:SHOLTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1144 COUNTY 693 AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNS
Mailing Address - State:KS
Mailing Address - Zip Code:67437-9048
Mailing Address - Country:US
Mailing Address - Phone:785-545-6993
Mailing Address - Fax:
Practice Address - Street 1:3601 CIMARRON PLZ
Practice Address - Street 2:SUITE 105
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2884
Practice Address - Country:US
Practice Address - Phone:402-463-2077
Practice Address - Fax:402-463-2062
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist