MEDICARE: JEANNE ELIZABETH COOPER

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
1	235Z00000X	Speech-Language Pathologist	SL008387	PA

General Provider Information

NPI Number	:	1891028551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE ELIZABETH COOPER

Provider Business Mailing Address
First Line	:	210 W UNION ST
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-3327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 W UNION ST
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-3327
Country	:	US
Telephone Number	:	215-668-2746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	09/14/2009

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Directions to “ JEANNE ELIZABETH COOPER ” Practice Location

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