Healthcare Provider Details

I. General information

NPI: 1386553246
Provider Name (Legal Business Name): STEFANIE GRACE KOSCH M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE KOSCH M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CENTENNIAL ST
COLUMBUS NE
68601-7305
US

IV. Provider business mailing address

375 S 7TH AVE
COLUMBUS NE
68601-7925
US

V. Phone/Fax

Practice location:
  • Phone: 402-563-8180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3071
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: