Willow Vivian Copulos
Willow Vivian Copulos is a Qualified Speech Language Pathologist in Staten Island, New York. Qualified in 2022, 4 years ago. Licensed in New York.
- Years since qualifying
- 4
- Licensed in
- NY
- In the registry since
- 2025
Practice location Address checks out
1415 Richmond AveStaten Island, NY 10314-1553
Phone: (877) 407-3422
Fax: (877) 407-4329
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Speech-Language Pathologist (primary) | Taxonomy 235Z00000X · Licence 033852 (NY) |
|---|
Record details
| NPI number | 1679458657 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | August 8, 2025 |
| Last updated in NPPES | August 8, 2025 |
| Certification date | August 8, 2025 |
Medicare enrollment
| Medicare specialty | QUALIFIED SPEECH LANGUAGE PATHOLOGIST |
|---|---|
| Medical school | OTHER |
| Graduated | 2022 (4 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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