Provider Demographics
NPI:1003308867
Name:GORBANDT, COURTNEY ELESE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:ELESE
Last Name:GORBANDT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:ELESE
Other - Last Name:ROWLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:12422 OLD MERIDIAN ST UNIT 106
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6112
Mailing Address - Country:US
Mailing Address - Phone:812-725-4797
Mailing Address - Fax:
Practice Address - Street 1:6239 S EAST ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2088
Practice Address - Country:US
Practice Address - Phone:317-791-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006906A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist