Provider Demographics
NPI:1295996577
Name:ATHMER, COURTNEY
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:ATHMER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:BRANDMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:
Mailing Address - City:ALBERS
Mailing Address - State:IL
Mailing Address - Zip Code:62215-0440
Mailing Address - Country:US
Mailing Address - Phone:618-550-8673
Mailing Address - Fax:618-624-8143
Practice Address - Street 1:1 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-6805
Practice Address - Country:US
Practice Address - Phone:618-624-8143
Practice Address - Fax:618-624-8143
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist