Provider Demographics
NPI:1295283208
Name:KOPCZYNSKI, TERI JOYCE (EDS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:JOYCE
Last Name:KOPCZYNSKI
Suffix:
Gender:F
Credentials:EDS CCC-SLP
Other - Prefix:MS
Other - First Name:TERI
Other - Middle Name:JOYCE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 COTTONDALE CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8430
Mailing Address - Country:US
Mailing Address - Phone:404-816-7936
Mailing Address - Fax:
Practice Address - Street 1:102 S HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3731
Practice Address - Country:US
Practice Address - Phone:410-838-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003112235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist