Provider Demographics
NPI:1528697885
Name:COCHRAN, TIMOTHY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:M
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 1:9943 LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1531
Mailing Address - Country:US
Mailing Address - Phone:785-317-3709
Mailing Address - Fax:
Practice Address - Street 1:2800 WILLOW GROVE RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2096
Practice Address - Country:US
Practice Address - Phone:785-539-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist