Provider Demographics
NPI:1639595721
Name:KLEE, COURTNAY (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:COURTNAY
Middle Name:
Last Name:KLEE
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SPEARS CREEK CHURCH RD
Mailing Address - Street 2:APARTMENT 313
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8299
Mailing Address - Country:US
Mailing Address - Phone:678-296-3315
Mailing Address - Fax:
Practice Address - Street 1:253 CRAIG MANOR RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6531
Practice Address - Country:US
Practice Address - Phone:803-286-1464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist