Provider Demographics
NPI:1538301031
Name:COPELAND, PRISCESSA LORINE (EDD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:PRISCESSA
Middle Name:LORINE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:EDD CCC-SLP
Other - Prefix:MRS
Other - First Name:PRISCESSA
Other - Middle Name:
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:406 ALACHUA ST
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-3511
Mailing Address - Country:US
Mailing Address - Phone:803-464-9824
Mailing Address - Fax:478-333-3666
Practice Address - Street 1:406 ALACHUA ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-3511
Practice Address - Country:US
Practice Address - Phone:803-464-9824
Practice Address - Fax:478-333-3666
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7859235Z00000X
GASLP008499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist