Provider Demographics
NPI:1417315821
Name:COOPER, SHERRIE JUNE (MS SPL CCC)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:JUNE
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS SPL CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 SILVA STREET
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290
Mailing Address - Country:US
Mailing Address - Phone:425-422-9901
Mailing Address - Fax:
Practice Address - Street 1:1131 SILVA STREET
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:425-422-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist