Provider Demographics
NPI:1679184196
Name:ORLOSKY, COURTNEY IRENE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:IRENE
Last Name:ORLOSKY
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 1:2015 GOLDMINE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-4418
Mailing Address - Country:US
Mailing Address - Phone:765-427-0289
Mailing Address - Fax:
Practice Address - Street 1:2015 GOLDMINE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-4418
Practice Address - Country:US
Practice Address - Phone:765-427-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist