Provider Demographics
NPI:1760950059
Name:COHEN, ELISHA BETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ELISHA
Middle Name:BETH
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2219
Mailing Address - Country:US
Mailing Address - Phone:908-230-9917
Mailing Address - Fax:
Practice Address - Street 1:65 PLAINS RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-2219
Practice Address - Country:US
Practice Address - Phone:908-230-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004780235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist