Provider Demographics
NPI:1083005128
Name:HARBOUR, COURTNEY
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HARBOUR
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 1:324 STEVENS ENTRY
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1325
Mailing Address - Country:US
Mailing Address - Phone:678-852-0282
Mailing Address - Fax:
Practice Address - Street 1:324 STEVENS ENTRY
Practice Address - Street 2:SUITE A-1
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1325
Practice Address - Country:US
Practice Address - Phone:678-852-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist