Provider Demographics
NPI:1013326263
Name:MURPHY, KOURTNEY ALEXIS (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:ALEXIS
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 ROOKS CT
Mailing Address - Street 2:APT 201
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2764
Mailing Address - Country:US
Mailing Address - Phone:240-418-4603
Mailing Address - Fax:
Practice Address - Street 1:6980 ROOKS CT
Practice Address - Street 2:APT 201
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2764
Practice Address - Country:US
Practice Address - Phone:240-418-4603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist