Provider Demographics
NPI:1992849210
Name:COGER, ELIZABETH GRACE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:GRACE
Last Name:COGER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 RED GATE LN
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3856
Mailing Address - Country:US
Mailing Address - Phone:781-710-9749
Mailing Address - Fax:
Practice Address - Street 1:57 HIGHLAND AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2141
Practice Address - Country:US
Practice Address - Phone:978-354-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6126235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist