Provider Demographics
NPI:1881017929
Name:GREGOIRE, COURTNEY JEANNE
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:JEANNE
Last Name:GREGOIRE
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 1:233 ROCKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1650
Mailing Address - Country:US
Mailing Address - Phone:508-858-1641
Mailing Address - Fax:
Practice Address - Street 1:233 ROCKDALE AVE
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-1650
Practice Address - Country:US
Practice Address - Phone:508-858-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health