Provider Demographics
NPI:1245875376
Name:BIRD, COURTNEY ROSE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ROSE
Last Name:BIRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-2324
Mailing Address - Country:US
Mailing Address - Phone:413-446-7762
Mailing Address - Fax:
Practice Address - Street 1:87 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-2324
Practice Address - Country:US
Practice Address - Phone:413-446-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist