Provider Demographics
NPI:1174970677
Name:COHEN, TERRI HASKINS (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:HASKINS
Last Name:COHEN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 CRABAPPLE RD
Mailing Address - Street 2:BLDG D SUITE 115-A
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2489
Mailing Address - Country:US
Mailing Address - Phone:770-642-0670
Mailing Address - Fax:770-642-0706
Practice Address - Street 1:11050 CRABAPPLE RD
Practice Address - Street 2:BLDG D SUITE 115-A
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2489
Practice Address - Country:US
Practice Address - Phone:770-642-0670
Practice Address - Fax:770-642-0706
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1587235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist