Basic Information
Provider Information
NPI: 1568719565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COCHET
FirstName: INGRID
MiddleName: ELISABETH
NamePrefix: MS.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 32 HIGHLAND AVENUE
Address2: APARTMENT 2
City: NORTHAMPTON
State: MA
PostalCode: 010603183
CountryCode: US
TelephoneNumber: 5084148430
FaxNumber:  
Practice Location
Address1: 349 HAYDENVILLE ROAD
Address2: LINDA MANOR
City: LEEDS
State: MA
PostalCode: 010530000
CountryCode: US
TelephoneNumber: 4135867700
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/08/2012
LastUpdateDate: 08/31/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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