Provider Demographics
NPI:1518112309
Name:WEISER, COURTNEY ALANNA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALANNA
Last Name:WEISER
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 1:1235 1ST AVE
Mailing Address - Street 2:APT 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6311
Mailing Address - Country:US
Mailing Address - Phone:917-548-7249
Mailing Address - Fax:
Practice Address - Street 1:825 W END AVE
Practice Address - Street 2:EARLY CHILDHOOD ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5349
Practice Address - Country:US
Practice Address - Phone:212-662-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0157961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist