Provider Demographics
NPI:1073848297
Name:COHEN, DEBORAH GALE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GALE
Last Name:COHEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:GALE
Other - Last Name:HENOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 BAYLIS PL
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-4204
Mailing Address - Country:US
Mailing Address - Phone:516-569-5591
Mailing Address - Fax:
Practice Address - Street 1:2 BAYLIS PL
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-4204
Practice Address - Country:US
Practice Address - Phone:516-569-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015413-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist