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General NPI Number Information
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NPI Number | 1174749048
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE COOPER MS CCCSLP
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 18230 FM 1488 RD # 328
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City | MAGNOLIA
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State | TX
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Zip | 77354-4528
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Country | US
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Telephone | 936-689-3874
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Fax | 830-460-2685
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Provider Business Mailing Address
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Address Line | 26702 STAGECOACH CROSSING DR
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City | MAGNOLIA
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State | TX
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Zip | 77355-2198
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Country | US
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Telephone | 832-934-2258
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 100078
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License Number State | TX
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