Provider Demographics
NPI:1205004637
Name:COCO, MCKINLEY (MS, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:MCKINLEY
Middle Name:
Last Name:COCO
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MARIE CURIE
Mailing Address - Street 2:C/O PM & R
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042
Mailing Address - Country:US
Mailing Address - Phone:972-487-5086
Mailing Address - Fax:972-485-3004
Practice Address - Street 1:2300 MARIE CURIE
Practice Address - Street 2:C/O PM & R
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042
Practice Address - Country:US
Practice Address - Phone:972-487-5086
Practice Address - Fax:972-485-3004
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL5774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist