Provider Demographics
NPI:1083863278
Name:COURTNEY, JUDITH E (MA-SLP)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:E
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BEAR TRAIL CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-8787
Mailing Address - Country:US
Mailing Address - Phone:501-455-1212
Mailing Address - Fax:
Practice Address - Street 1:22 BEAR TRAIL CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-8787
Practice Address - Country:US
Practice Address - Phone:501-455-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR923165244OtherDRIVER'S LICENSE