Provider Demographics
NPI:1336761683
Name:CASEY, COURTNEY LOUISE (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LOUISE
Last Name:CASEY
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SARELLA ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2453
Mailing Address - Country:US
Mailing Address - Phone:518-681-7787
Mailing Address - Fax:
Practice Address - Street 1:413 BAY RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1408
Practice Address - Country:US
Practice Address - Phone:518-761-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program