Provider Demographics
NPI:1477036002
Name:COOPE, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COOPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2220 N CAMINO PRINCIPAL STE D
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5305
Mailing Address - Country:US
Mailing Address - Phone:520-800-2956
Mailing Address - Fax:520-800-2956
Practice Address - Street 1:2220 N CAMINO PRINCIPAL STE D
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5305
Practice Address - Country:US
Practice Address - Phone:520-800-2956
Practice Address - Fax:520-800-2956
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist