MEDICARE: MRS. ELIZABETH WEBB COOKSEY M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	24793	TX

General Provider Information

NPI Number	:	1558533877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH WEBB COOKSEY M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	4448 MOCKINGBIRD LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2618
Country	:	US
Telephone Number	:	214-794-4060
Fax Number	:

Provider Business Practice Location Address
First Line	:	4448 MOCKINGBIRD LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-2618
Country	:	US
Telephone Number	:	214-794-4060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/26/2008

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