Provider Demographics
NPI:1023396793
Name:COOPER, ELIZABETH J (AUD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:COOPER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 ROCKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2172
Mailing Address - Country:US
Mailing Address - Phone:216-986-4000
Mailing Address - Fax:216-986-4992
Practice Address - Street 1:5001 ROCKSIDE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2172
Practice Address - Country:US
Practice Address - Phone:216-986-4000
Practice Address - Fax:216-986-4992
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000689231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist