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General NPI Number Information
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NPI Number | 1396325403
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Entity Type | Individual
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Provider Name | SHAQUILLE COOPER M.S. CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 8135 PAINTER AVE STE 201
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City | WHITTIER
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State | CA
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Zip | 90602-3166
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Country | US
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Telephone | 562-698-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 7160 N ATLANTIC PL
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City | LONG BEACH
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State | CA
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Zip | 90805-1040
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Country | US
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Telephone | 562-314-7174
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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 | 28846
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License Number State | CA
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