Provider Demographics
NPI:1487651188
Name:COHEN, CASSIE (AUD, F-AAA)
Entity type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:AUD, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8228 SILKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-5957
Mailing Address - Country:US
Mailing Address - Phone:404-309-5159
Mailing Address - Fax:
Practice Address - Street 1:4520 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3914
Practice Address - Country:US
Practice Address - Phone:630-821-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000585231H00000X
VA2101000853237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA64BCBNJMedicare ID - Type Unspecified