Provider Demographics
NPI:1245547017
Name:INGALLS, COURTNEY JO (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:JO
Last Name:INGALLS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:JO
Other - Last Name:BEGANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3812 LEYLAND DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-7634
Mailing Address - Country:US
Mailing Address - Phone:717-439-1704
Mailing Address - Fax:
Practice Address - Street 1:102 CHANDRA DR
Practice Address - Street 2:
Practice Address - City:DUNCANNON
Practice Address - State:PA
Practice Address - Zip Code:17020-9745
Practice Address - Country:US
Practice Address - Phone:717-834-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist