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NPI Code Detail

MEDICARE: TAMMY KOSEK CCC-SLP

MEDICARE: TAMMY KOSEK CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistMN7412MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14600790OTHERMNMEDICA PROVIDER ID
241163580956301B017OTHERMNCHAMPUS
3284L4UEOTHERMNBCBS PROVIDER ID
4HP46883OTHERMNHEALTHPARTNERS ID

General Provider Information

NPI Number : 1447233929
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY KOSEK CCC-SLP
Provider Business Mailing Address
First Line : 2835 W SAINT GERMAIN ST
Second Line : SUITE 300
City : SAINT CLOUD
State : MN
Zip : 56301-4743
Country : US
Telephone Number : 320-259-4151
Fax Number : 320-259-5707
Provider Business Practice Location Address
First Line : 2835 W SAINT GERMAIN ST
Second Line : SUITE 300
City : SAINT CLOUD
State : MN
Zip : 56301-4743
Country : US
Telephone Number : 320-259-4151
Fax Number : 320-259-5707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/08/2007

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Directions to “ TAMMY KOSEK CCC-SLP” Practice Location

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