Provider Demographics
NPI:1457409336
Name:COHEN, PATRICIA ANN (MA, CCC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W CENTRAL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1378
Mailing Address - Country:US
Mailing Address - Phone:610-408-9250
Mailing Address - Fax:
Practice Address - Street 1:7 W CENTRAL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1378
Practice Address - Country:US
Practice Address - Phone:610-408-9250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000887L231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA212088OtherPERSONAL CHOICE
PACO212088OtherBLUE SHIELD
PA25112829OtherAETNA
PA0719149000OtherKEYSTONE
PACO046406Medicare ID - Type UnspecifiedMEDICARE
PA212088OtherPERSONAL CHOICE