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NPI Code Detail

MEDICARE: MRS. COURTNEY EVELYN COPPAGE MS SLP

MEDICARE: MRS. COURTNEY EVELYN COPPAGE MS 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 Pathologist2202006994VA

General Provider Information

NPI Number : 1639510878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COURTNEY EVELYN COPPAGE MS SLP
Provider Business Mailing Address
First Line : 601 MEADOWBROOK DR
Second Line :
City : CULPEPER
State : VA
Zip : 22701-3949
Country : US
Telephone Number : 571-921-2589
Fax Number :
Provider Business Practice Location Address
First Line : 3500 MEEKINS DR
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-4894
Country : US
Telephone Number : 540-785-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2013
Last Update Date : 07/16/2013

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