Provider Demographics
NPI:1215127915
Name:MCOSKER, CYNTHIA ANN (MA MED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:MCOSKER
Suffix:
Gender:F
Credentials:MA MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SCAMMAN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-4536
Mailing Address - Country:US
Mailing Address - Phone:207-799-9145
Mailing Address - Fax:
Practice Address - Street 1:140 SCAMMAN ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-4536
Practice Address - Country:US
Practice Address - Phone:207-799-9145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-28
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP 290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME060221OtherANTHEM
ME7435486OtherAETNA