Provider Demographics
NPI:1356086078
Name:VEASEY, COURTNEY (SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:VEASEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7095 WILL ROBBINS HWY
Mailing Address - Street 2:
Mailing Address - City:NETTLETON
Mailing Address - State:MS
Mailing Address - Zip Code:38858-6062
Mailing Address - Country:US
Mailing Address - Phone:662-213-5815
Mailing Address - Fax:
Practice Address - Street 1:7095 WILL ROBBINS HWY
Practice Address - Street 2:
Practice Address - City:NETTLETON
Practice Address - State:MS
Practice Address - Zip Code:38858-6062
Practice Address - Country:US
Practice Address - Phone:662-213-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-4789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist