Provider Demographics
NPI:1437446069
Name:HAGGARD, COURTNEY SHEA (MA SLP-CFY)
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:SHEA
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:MA SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BEAUMONT CENTRE LN
Mailing Address - Street 2:APT. 21108
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1758
Mailing Address - Country:US
Mailing Address - Phone:606-344-6068
Mailing Address - Fax:
Practice Address - Street 1:1101 BEAUMONT CENTRE LN
Practice Address - Street 2:APT. 21108
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1758
Practice Address - Country:US
Practice Address - Phone:606-344-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11-040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist