Provider Demographics
NPI:1013229921
Name:PAUL, COURTNEY GUIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:GUIN
Last Name:PAUL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 BRITTANY LN
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2172
Mailing Address - Country:US
Mailing Address - Phone:318-990-9833
Mailing Address - Fax:
Practice Address - Street 1:817 BRITTANY LN
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2172
Practice Address - Country:US
Practice Address - Phone:318-990-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist