Provider Demographics
NPI:1265663298
Name:THIMS, COURTNEY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:THIMS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PINELOCH DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2910
Mailing Address - Country:US
Mailing Address - Phone:207-899-0714
Mailing Address - Fax:
Practice Address - Street 1:24 PINELOCH DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2910
Practice Address - Country:US
Practice Address - Phone:207-899-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist