Provider Demographics
NPI:1942411558
Name:COKER, LESA BURR (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESA
Middle Name:BURR
Last Name:COKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREEN APPLE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2561
Mailing Address - Country:US
Mailing Address - Phone:972-675-6824
Mailing Address - Fax:972-675-6824
Practice Address - Street 1:501 GREEN APPLE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2561
Practice Address - Country:US
Practice Address - Phone:972-675-6824
Practice Address - Fax:972-675-6824
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist