Provider Demographics
NPI:1720053028
Name:COHEN, EMILIE JANET (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILIE
Middle Name:JANET
Last Name:COHEN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 SILVER LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-3773
Mailing Address - Country:US
Mailing Address - Phone:904-284-4498
Mailing Address - Fax:
Practice Address - Street 1:2140 KINGSLEY AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5180
Practice Address - Country:US
Practice Address - Phone:904-272-2830
Practice Address - Fax:904-272-8814
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist