Individual
MS. MICHELLE LATRICE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
318 BLUESTEM DR, ELGIN, SC 29045-2103
(803) 928-0369
(866) 524-1024
Mailing address
PO BOX 290115, COLUMBIA, SC 29229-0002
(803) 928-0369
(866) 524-1024
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3368
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0518
—
SC
Enumeration date
11/30/2006
Last updated
10/15/2023
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