Provider Demographics
NPI:1619429362
Name:COPSEY, CRISTI
Entity Type:Individual
Prefix:MS
First Name:CRISTI
Middle Name:
Last Name:COPSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82257 LINSCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ANSELMO
Mailing Address - State:NE
Mailing Address - Zip Code:68813-7839
Mailing Address - Country:US
Mailing Address - Phone:308-530-7632
Mailing Address - Fax:
Practice Address - Street 1:82257 LINSCOTT AVE
Practice Address - Street 2:
Practice Address - City:ANSELMO
Practice Address - State:NE
Practice Address - Zip Code:68813-7839
Practice Address - Country:US
Practice Address - Phone:308-530-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist