Provider Demographics
NPI:1053541516
Name:LOSER, MIA USSERY (MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MIA
Middle Name:USSERY
Last Name:LOSER
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDGARD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-6509
Mailing Address - Country:US
Mailing Address - Phone:803-463-9780
Mailing Address - Fax:
Practice Address - Street 1:5 MIDGARD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-6509
Practice Address - Country:US
Practice Address - Phone:803-463-9780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-19
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist