Shelby Kate Cooper

Individual provider Active NPI Speech-Language Pathologist · Hermann, MO

NPI 1780162933 · NPPES record last updated Jul 31, 2018

Key facts

NPI
1780162933
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2017003651 (MO)
Practice address
328 W 7TH St
Hermann, MO 65041-1216
Phone
(573) 486-3197
Fax
(573) 486-3244
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2017003651MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2017003651 MO Yes

Addresses

Primary practice location

328 W 7TH St
Hermann, MO 65041-1216

Mailing address

170 Blue Pride Dr
Hermann, MO 65041-1593
Phone (573) 486-3197

Other practice location 1

176 Bearcat Xing
Hermann, MO 65041-1594
Phone (573) 486-2116 ext. 1110

Other providers in Hermann, MO

All providers in Hermann, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.