Healthcare Provider Details

I. General information

NPI: 1699157685
Provider Name (Legal Business Name): SABRINA ANDERSON COHEN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 BLAND ST
RICHMOND VA
23225-4725
US

IV. Provider business mailing address

219 BLAND ST
RICHMOND VA
23225-4725
US

V. Phone/Fax

Practice location:
  • Phone: 615-945-4989
  • Fax:
Mailing address:
  • Phone: 615-945-4989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202007930
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: