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General NPI Number Information
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NPI Number | 1265585848
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Entity Type | Individual
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Provider Name | TAMARA J COSBY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 41421 DATE ST STE 101
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 858-469-7275
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Fax |
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Provider Business Mailing Address
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Address Line | 43490 CORTE AYALA
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City | TEMECULA
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State | CA
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Zip | 92592-3776
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Country | US
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Telephone | 951-852-8812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-860
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18696
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License Number State | CA
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