Doctor Name: | MS. VICTORIA COOPER |
NPI Number: | 1326374638 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 146.009742 |
Business Practice Address: | 500 Centennial Dr East Peoria, IL - 616114912 |
Business Phone Number: | 3096949865 |
Business Fax Number: | |
Mailing Address: | 719 N Pleasant Hill Rd, EAST PEORIA |
State: | IL |
Postal Code: | 616119366 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/20/2009 |
NPI Last Update Date: | 10/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.009742 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |