Provider Demographics
NPI:1124539259
Name:KOPF, JAMES CHESTER JR (MA/CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHESTER
Last Name:KOPF
Suffix:JR
Gender:M
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CARTER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-9634
Mailing Address - Country:US
Mailing Address - Phone:336-342-2147
Mailing Address - Fax:
Practice Address - Street 1:305 CARTER RIDGE DR
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-9634
Practice Address - Country:US
Practice Address - Phone:336-342-2147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005173235Z00000X
NC3446235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist