Provider Demographics
NPI:1063813426
Name:COATES, KATHLEEN TOLIN (AUD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:TOLIN
Last Name:COATES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 E BOOKER DAIRY RD # 200
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9405
Mailing Address - Country:US
Mailing Address - Phone:919-300-5438
Mailing Address - Fax:919-364-1726
Practice Address - Street 1:1652 E BOOKER DAIRY RD # 200
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9405
Practice Address - Country:US
Practice Address - Phone:919-300-5438
Practice Address - Fax:919-364-1726
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11115237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter