Provider Demographics
NPI:1942976444
Name:COGGINS, KATHLEEN A (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:COGGINS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10809 SYMPHONY WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4927
Mailing Address - Country:US
Mailing Address - Phone:484-354-6445
Mailing Address - Fax:
Practice Address - Street 1:7030 BANBURY DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-2101
Practice Address - Country:US
Practice Address - Phone:410-313-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02376L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist