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NPI 1679238521

NPI 1679238521 : MARGARET ELLA COFFEY CCC-SLP : LAKE WORTH, TX

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General NPI Number Information
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    NPI Number           |    1679238521
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    Entity Type          |    Individual 
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    Provider Name        |    MARGARET ELLA COFFEY CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2021
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    Last Update Date     |    11/05/2021
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Provider Practice Location Address
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    Address Line         |    3801 MERRETT DR 
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    City                 |    LAKE WORTH
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    State                |    TX
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    Zip                  |    76135-3505
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    Country              |    US
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    Telephone            |    817-306-4200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6805 TELEPHONE RD 
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    City                 |    LAKE WORTH
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    State                |    TX
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    Zip                  |    76135-2855
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    115326
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    License Number State |    TX
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