Provider Demographics
NPI:1548156300
Name:BOSNICK, COURTNEY AMBER
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:AMBER
Last Name:BOSNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 DUNKIRK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2015
Mailing Address - Country:US
Mailing Address - Phone:443-310-5198
Mailing Address - Fax:
Practice Address - Street 1:10753 BIRMINGHAM WAY STE A
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:MD
Practice Address - Zip Code:21163-1535
Practice Address - Country:US
Practice Address - Phone:240-200-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03101L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist