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NPI Code Detail

MEDICARE: COURTNEY NICOLE COOPER MS CCC-SLP

MEDICARE: COURTNEY NICOLE COOPER MS 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 Pathologist5661AL

General Provider Information

NPI Number : 1083410005
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY NICOLE COOPER MS CCC-SLP
Provider Business Mailing Address
First Line : 7626 SPANISH FORT BLVD
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5376
Country : US
Telephone Number : 251-929-4848
Fax Number : 251-850-5080
Provider Business Practice Location Address
First Line : 7626 SPANISH FORT BLVD
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5376
Country : US
Telephone Number : 251-929-4848
Fax Number : 251-850-5080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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Directions to “ COURTNEY NICOLE COOPER MS CCC-SLP” Practice Location

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