Provider Demographics
NPI:1255679908
Name:NEESE, CORTNEY MARIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CORTNEY
Middle Name:MARIE
Last Name:NEESE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:CORTNEY
Other - Middle Name:MARIE
Other - Last Name:SOURWINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 51322
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-5622
Mailing Address - Country:US
Mailing Address - Phone:270-777-9283
Mailing Address - Fax:270-777-9283
Practice Address - Street 1:1040 MARKET ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4855
Practice Address - Country:US
Practice Address - Phone:270-827-4652
Practice Address - Fax:270-831-1182
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYABALBA00218602103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst