Provider Demographics
NPI:1023793163
Name:COPLEY, SONYA (SLP-CCC)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:COPLEY
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 RUSE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MANCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46962-1243
Mailing Address - Country:US
Mailing Address - Phone:260-578-9578
Mailing Address - Fax:
Practice Address - Street 1:1900 ALBER ST
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1018
Practice Address - Country:US
Practice Address - Phone:260-563-7427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003792A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist