Provider Demographics
NPI:1376795062
Name:MILFORD, COURTNEY H (MS)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:H
Last Name:MILFORD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:HOLDERLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5484 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:CONESUS
Mailing Address - State:NY
Mailing Address - Zip Code:14435-9587
Mailing Address - Country:US
Mailing Address - Phone:585-727-3319
Mailing Address - Fax:
Practice Address - Street 1:5484 MISSION RD
Practice Address - Street 2:
Practice Address - City:CONESUS
Practice Address - State:NY
Practice Address - Zip Code:14435-9587
Practice Address - Country:US
Practice Address - Phone:585-727-3319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018401-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30-0213081OtherTAX ID