Provider Demographics
NPI:1558651257
Name:MCCOURTIE, MARCI (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARCI
Middle Name:
Last Name:MCCOURTIE
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 1:7950 DUBLIN BLVD
Mailing Address - Street 2:SUITE 208A
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2929
Mailing Address - Country:US
Mailing Address - Phone:925-361-7663
Mailing Address - Fax:925-361-7663
Practice Address - Street 1:7950 DUBLIN BLVD
Practice Address - Street 2:SUITE 208A
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2929
Practice Address - Country:US
Practice Address - Phone:925-361-7663
Practice Address - Fax:925-361-7663
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 10849235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist