Provider Demographics
NPI:1225033533
Name:COHEN, BETSY JANE (FAAA)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:JANE
Last Name:COHEN
Suffix:
Gender:F
Credentials:FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 REVOLUTION ST
Mailing Address - Street 2:HAVRE DE GRACE
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3718
Mailing Address - Country:US
Mailing Address - Phone:410-939-2030
Mailing Address - Fax:410-939-2031
Practice Address - Street 1:920 REVOLUTION ST
Practice Address - Street 2:HAVRE DE GRACE
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3718
Practice Address - Country:US
Practice Address - Phone:410-939-2030
Practice Address - Fax:410-939-2031
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD460231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0005749633OtherAETNA
MD374948700 183421Medicaid
MD0005749633OtherAETNA
C49165Medicare UPIN