Provider Demographics
NPI:1821868779
Name:HUMMEL, COURTNEY MIKU
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MIKU
Last Name:HUMMEL
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 1:7251 SW 99TH ST
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3115
Mailing Address - Country:US
Mailing Address - Phone:178-641-4832
Mailing Address - Fax:
Practice Address - Street 1:8785 SW 165TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5826
Practice Address - Country:US
Practice Address - Phone:305-900-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL65382355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant