Provider Demographics
NPI:1306580923
Name:COGGINS, LILAH MAE
Entity type:Individual
Prefix:
First Name:LILAH
Middle Name:MAE
Last Name:COGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:DEWALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1060 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-3586
Mailing Address - Country:US
Mailing Address - Phone:719-579-2030
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1060 HARRISON RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-3586
Practice Address - Country:US
Practice Address - Phone:719-579-2030
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24528390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist