| Doctor Name: | BREANA COOPER |
| NPI Number: | 1962867481 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 111384 |
| Business Practice Address: | 600 S Tyler St Ste 805 Amarillo, TX - 791012353 |
| Business Phone Number: | 8065537780 |
| Business Fax Number: | 8065537771 |
| Mailing Address: | 4217 S Travis St, AMARILLO |
| State: | TX |
| Postal Code: | 791101829 |
| Phone Number: | 8066541465 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2015 |
| NPI Last Update Date: | 12/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 111384 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| 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 |