Provider Demographics
NPI:1194018440
Name:COOPER, DEBRA HUTHER (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:HUTHER
Last Name:COOPER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HIGH RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1720
Mailing Address - Country:US
Mailing Address - Phone:978-465-1073
Mailing Address - Fax:
Practice Address - Street 1:35 HIGH RD
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01951-1720
Practice Address - Country:US
Practice Address - Phone:978-465-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist