Provider Demographics
NPI:1548580202
Name:COOPER, ASHLEY J (SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:COOPER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 PAR LN APT 1008
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-2941
Mailing Address - Country:US
Mailing Address - Phone:330-647-2525
Mailing Address - Fax:
Practice Address - Street 1:14900 PRIVATE DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44112-3470
Practice Address - Country:US
Practice Address - Phone:216-851-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND2010164235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist