Provider Demographics
NPI:1649566647
Name:COHEN, LEE ANN (MA CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:LEE ANN
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 SPENCERPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1942
Mailing Address - Country:US
Mailing Address - Phone:585-349-5355
Mailing Address - Fax:
Practice Address - Street 1:2749 SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1942
Practice Address - Country:US
Practice Address - Phone:585-349-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015038235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist