Provider Demographics
NPI:1801228028
Name:ACQUARD, COURTNEY (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:ACQUARD
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 POUND RD
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9680
Mailing Address - Country:US
Mailing Address - Phone:716-481-2481
Mailing Address - Fax:
Practice Address - Street 1:6490 TAYLOR RD LOT 17
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-6565
Practice Address - Country:US
Practice Address - Phone:877-246-2396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist