Provider Demographics
NPI:1770708216
Name:COOPER, AMY LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:COOPER
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:9 TUSCAN RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2712
Mailing Address - Country:US
Mailing Address - Phone:917-721-5808
Mailing Address - Fax:646-438-7809
Practice Address - Street 1:380 2ND AVE FL 9
Practice Address - Street 2:VOICE AND SWALLOWING INSTITUTE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5645
Practice Address - Country:US
Practice Address - Phone:646-438-7883
Practice Address - Fax:646-438-7860
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY014046-1235Z00000X
NJ41YS00889500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist