Provider Demographics
NPI:1851554810
Name:CRACE, COURTNEY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:CRACE
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 1:3441 ALDERSHOT DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4201
Mailing Address - Country:US
Mailing Address - Phone:859-806-5717
Mailing Address - Fax:877-804-4492
Practice Address - Street 1:3441 ALDERSHOT DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-4201
Practice Address - Country:US
Practice Address - Phone:859-806-5717
Practice Address - Fax:877-804-4492
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist