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Individual
KIMBERLY PAGE COOPER
Active
Individual
KIMBERLY PAGE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277041361B
—
GA
01
—
SLP007349
GA LICENSE
GA
Enumeration date
07/01/2010
Last updated
09/06/2022
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