Provider Demographics
NPI:1255845244
Name:COPUS, KATELYN E (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:E
Last Name:COPUS
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 1:718 E ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-5731
Mailing Address - Country:US
Mailing Address - Phone:815-232-0480
Mailing Address - Fax:
Practice Address - Street 1:718 E ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-5731
Practice Address - Country:US
Practice Address - Phone:815-232-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist