Provider Demographics
NPI:1598595068
Name:WEDDLE-COATS, MCKENZIE ELIZABETH
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:ELIZABETH
Last Name:WEDDLE-COATS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-1851
Mailing Address - Country:US
Mailing Address - Phone:337-521-7610
Mailing Address - Fax:
Practice Address - Street 1:400 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1851
Practice Address - Country:US
Practice Address - Phone:337-521-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist