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General NPI Number Information
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NPI Number | 1952734931
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Entity Type | Individual
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Provider Name | ELIZABETH COBBLE
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Gender | Female
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 555 AMORY ST THOM BOSTON METRO EI.
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2652
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Country | US
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Telephone | 617-383-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 4154 TRAVIS COUNTRY CIR
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City | AUSTIN
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State | TX
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Zip | 78735-6337
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Country | US
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Telephone | 571-239-5416
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 112353
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License Number State | TX
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