Provider Demographics
NPI:1306582135
Name:COTNER, MAKENAH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MAKENAH
Middle Name:
Last Name:COTNER
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 1:8600 N FM 620 RD APT 2332
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-3569
Mailing Address - Country:US
Mailing Address - Phone:713-504-8981
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD STE 206
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5552
Practice Address - Country:US
Practice Address - Phone:512-284-8964
Practice Address - Fax:512-284-8966
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist