Individual ProviderSamantha CozzolinoSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address22 Bramhall St, Portland, ME 04102-3175(207) 662-0111(203) 907-8043PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Cozzolino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1912570649Provider TypeIndividualFull NameCozzolino, SamanthaCredentialCF-SLPGenderFemaleSole ProprietorYesEnumeration Date7/20/2021Last Updated10/18/2024Contact InformationPractice LocationPractice Address22 Bramhall St, Portland, ME 04102-3175Phone(207) 662-0111FaxUnlisted FaxMailing LocationMailing Address273 Lane St, Hamden, CT 06514-2718Phone(203) 907-8043FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseUnlisted IssuerConnecticut