| Doctor Name: | SHANNON M COOPER |
| NPI Number: | 1770711319 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 17434 |
| Business Practice Address: | 802 Magnolia Ave Suite 107 Corona, CA - 928793104 |
| Business Phone Number: | 9513400070 |
| Business Fax Number: | 9513409188 |
| Mailing Address: | 1230 E Washington St, Suite Pa-2 COLTON |
| State: | CA |
| Postal Code: | 923246450 |
| Phone Number: | 9098256716 |
| Fax Number: | 9098254339 |
| NPI Enumeration Date: | 06/22/2009 |
| NPI Last Update Date: | 06/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 17434 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| 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 |