Provider Demographics
NPI:1376935551
Name:COHEN, SHERI BETH (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:BETH
Last Name:COHEN
Suffix:
Gender:F
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 1:200 LITTLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:ME
Mailing Address - Zip Code:04444-5137
Mailing Address - Country:US
Mailing Address - Phone:207-234-2354
Mailing Address - Fax:
Practice Address - Street 1:84 SCHOOL ST
Practice Address - Street 2:MSAD 3 OFFICE OF PUPIL SERVICES
Practice Address - City:UNITY
Practice Address - State:ME
Practice Address - Zip Code:04988-3911
Practice Address - Country:US
Practice Address - Phone:207-948-6136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MESP2396OtherMAINE STATE PROFESSIONAL LICENSE