Individual
JENNA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2509 S 4TH ST, PHILADELPHIA, PA 19148-4712
(215) 462-3142
Mailing address
1500 LOCUST ST, APT 2713, PHILADELPHIA, PA 19102-4329
(267) 519-0830
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL008838
PA
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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