Provider Demographics
NPI:1134136781
Name:COHEN, BEVERLY ROSE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:BEVERLY
Middle Name:ROSE
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MARLTON PIKE W
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3048
Mailing Address - Country:US
Mailing Address - Phone:856-429-8703
Mailing Address - Fax:856-616-9221
Practice Address - Street 1:300 MARLTON PIKE W
Practice Address - Street 2:SUITE 107
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3048
Practice Address - Country:US
Practice Address - Phone:856-429-8703
Practice Address - Fax:856-616-9221
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00190000235Z00000X
PASL002914L235Z00000X
FLSA7159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist