Provider Demographics
NPI:1538515697
Name:COPELAND, NANCY RENEE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:RENEE
Last Name:COPELAND
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 1:16996 STATE ROUTE 198
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9424
Mailing Address - Country:US
Mailing Address - Phone:419-204-2339
Mailing Address - Fax:
Practice Address - Street 1:1010 E NATIONAL RD
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-3204
Practice Address - Country:US
Practice Address - Phone:937-415-6540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.11356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist