Doctor Name: | BETHANN BODDUM COFFIN |
NPI Number: | 1275825390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | SP10153 |
Business Practice Address: | 150 Grand Ave Suite 101 Oakland, CA - 946123781 |
Business Phone Number: | 5104515800 |
Business Fax Number: | 5104515802 |
Mailing Address: | 448 Cumberland Dr, PLEASANT HILL |
State: | CA |
Postal Code: | 945234049 |
Phone Number: | 9252568382 |
Fax Number: | 9252568382 |
NPI Enumeration Date: | 05/08/2011 |
NPI Last Update Date: | 05/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP10153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |