Doctor Name: | MRS. MARY KATHRYN COBURN |
NPI Number: | 1417263526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | LL 60390353 |
Business Practice Address: | 18223 Rampart Dr Se Yelm, WA - 985979018 |
Business Phone Number: | 5754423405 |
Business Fax Number: | |
Mailing Address: | 18223 Rampart Dr Se, YELM |
State: | WA |
Postal Code: | 985979018 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/26/2010 |
NPI Last Update Date: | 06/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | LL 60390353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |