Provider Demographics
NPI:1023422672
Name:COURET, TATIANA (MS-PHL)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:COURET
Suffix:
Gender:F
Credentials:MS-PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 COND RIO VIS APT G41
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8781
Mailing Address - Country:US
Mailing Address - Phone:787-487-8274
Mailing Address - Fax:
Practice Address - Street 1:70 COND RIO VIS APT G41
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8781
Practice Address - Country:US
Practice Address - Phone:787-487-8274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist