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NPI Code Detail

MEDICARE: MARY COPELAND M.S., CCC-SLP

MEDICARE: MARY COPELAND M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4375TN

General Provider Information

NPI Number : 1255670279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY COPELAND M.S., CCC-SLP
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 7007 STAGE RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38133-4977
Country : US
Telephone Number : 901-677-0422
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2013
Last Update Date : 09/18/2024

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Directions to “ MARY COPELAND M.S., CCC-SLP” Practice Location

Language Start Address Practice Location
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