Provider Demographics
NPI:1972917169
Name:COPES, AMANDA (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:COPES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 VERA KING FARRIS DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9441
Mailing Address - Country:US
Mailing Address - Phone:609-652-4920
Mailing Address - Fax:609-404-4546
Practice Address - Street 1:10 W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9401
Practice Address - Country:US
Practice Address - Phone:609-652-4920
Practice Address - Fax:609-404-4645
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00670400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist