Individual
ELIZABETH COENEN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
17028 LEJEUNE ROAD, QUANTICO, VA 22134-1757
(703) 217-3511
(703) 221-6905
Mailing address
335 BAHIA LN, CAPE CARTERET, NC 28584-9356
(703) 217-3511
(252) 764-2436
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004656
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010125961
—
VA
01
—
194110
ANTHEM BCBS
VA
01
—
201511442
UNITED HEALTHCARE
VA
01
—
2157798
MAMSI
VA
Enumeration date
06/22/2005
Last updated
07/24/2008
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