Provider Demographics
NPI:1619264876
Name:COHEN, FERN A (CCC-SLP#0348)
Entity Type:Individual
Prefix:MRS
First Name:FERN
Middle Name:A
Last Name:COHEN
Suffix:
Gender:F
Credentials:CCC-SLP#0348
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11802 EDINBOROUGH SQ
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-3413
Mailing Address - Country:US
Mailing Address - Phone:804-308-1238
Mailing Address - Fax:
Practice Address - Street 1:2027 LAUDERDALE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-3940
Practice Address - Country:US
Practice Address - Phone:804-421-5250
Practice Address - Fax:804-421-5251
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist