Provider Demographics
NPI:1215243498
Name:COTANCH, NATALIE (SLPA)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:COTANCH
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 DENTON HWY
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-3710
Mailing Address - Country:US
Mailing Address - Phone:817-831-1078
Mailing Address - Fax:817-831-1730
Practice Address - Street 1:3145 DENTON HWY
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-3710
Practice Address - Country:US
Practice Address - Phone:817-831-1078
Practice Address - Fax:817-831-1730
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353182355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149984001Medicaid
TX207164901Medicaid
TX207164901Medicaid
TX149984001Medicaid