Provider Demographics
NPI:1598057408
Name:HARPER, COURTNEY R (OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:R
Last Name:HARPER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 GOODES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-3109
Mailing Address - Country:US
Mailing Address - Phone:770-807-5011
Mailing Address - Fax:
Practice Address - Street 1:5539 HWY 47
Practice Address - Street 2:
Practice Address - City:CHASE CITY
Practice Address - State:VA
Practice Address - Zip Code:23924-3727
Practice Address - Country:US
Practice Address - Phone:434-372-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005258171W00000X
VA0119005638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor