Provider Demographics
NPI:1629388541
Name:COPE, KAITLIN M (SLP)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:M
Last Name:COPE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:KAITLIN
Other - Middle Name:M
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1603 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-1834
Mailing Address - Country:US
Mailing Address - Phone:315-455-7591
Mailing Address - Fax:
Practice Address - Street 1:1603 COURT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-1834
Practice Address - Country:US
Practice Address - Phone:315-455-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020098235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist