Provider Demographics
NPI:1962125898
Name:COHEN, GENEVIEVE (SLP PROV LICENSE)
Entity type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:SLP PROV LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 PERSPECTIVE PL
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-5955
Mailing Address - Country:US
Mailing Address - Phone:412-320-5650
Mailing Address - Fax:
Practice Address - Street 1:4599 SUMMIT POINT RD
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4673
Practice Address - Country:US
Practice Address - Phone:304-728-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVE3C145900255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist