Provider Demographics
NPI:1891194486
Name:CANEZ, COURTNEY RAE (SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:CANEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19818 W US HIGHWAY 85
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-9258
Mailing Address - Country:US
Mailing Address - Phone:623-327-2819
Mailing Address - Fax:623-327-2819
Practice Address - Street 1:19818 W US HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-9258
Practice Address - Country:US
Practice Address - Phone:623-327-2819
Practice Address - Fax:623-327-2819
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP9016235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist