Provider Demographics
NPI:1962548156
Name:KLEIN, CAROLYN AILEEN COSS (MS)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:AILEEN COSS
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:AILEEN
Other - Last Name:COSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:111 CHAMBERS HILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7304
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:111 CHAMBERS HILL DR STE 101
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-7304
Practice Address - Country:US
Practice Address - Phone:717-709-7997
Practice Address - Fax:717-261-4725
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004402L235Z00000X
PAAT000836L237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017696980006Medicaid