Provider Demographics
NPI:1851156103
Name:PIPER, COURTNEY SHANICE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SHANICE
Last Name:PIPER
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 1:6266 DORSETT SHOALS RD LOT 136
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4662
Mailing Address - Country:US
Mailing Address - Phone:302-538-4035
Mailing Address - Fax:
Practice Address - Street 1:6266 DORSETT SHOALS RD LOT 136
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4662
Practice Address - Country:US
Practice Address - Phone:302-538-4035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician