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NPI Code Detail

MEDICARE: MS. KATHRYN YOUNG COPPER SLP

MEDICARE:  MS. KATHRYN YOUNG COPPER  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 PathologistSLP001830GA

General Provider Information

NPI Number : 1164647590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN YOUNG COPPER SLP
Provider Business Mailing Address
First Line : PO BOX 1692
Second Line :
City : DECATUR
State : GA
Zip : 30031-1692
Country : US
Telephone Number : 404-249-8860
Fax Number : 404-881-6854
Provider Business Practice Location Address
First Line : 807 NORTH AVE NE
Second Line :
City : ATLANTA
State : GA
Zip : 30306-4332
Country : US
Telephone Number : 404-248-8860
Fax Number : 404-881-6854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 07/09/2007

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Directions to “ MS. KATHRYN YOUNG COPPER SLP” Practice Location

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