Provider Demographics
NPI:1477326445
Name:MARKS, COURTNEY (SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MARKS
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 1:17732 HIGHLAND RD, STE G, BOX 243
Mailing Address - Street 2:NA
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-292-4138
Mailing Address - Fax:
Practice Address - Street 1:18268 PETROLEUM DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-6126
Practice Address - Country:US
Practice Address - Phone:225-292-4138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist