Provider Demographics
NPI:1205721875
Name:DEAN, KOURTNEY (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KOURTNEY
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 BLUEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2105
Mailing Address - Country:US
Mailing Address - Phone:702-349-2377
Mailing Address - Fax:
Practice Address - Street 1:450 N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7814
Practice Address - Country:US
Practice Address - Phone:314-720-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist