Provider Demographics
NPI:1952828774
Name:FONTENOT, COURTNI
Entity type:Individual
Prefix:
First Name:COURTNI
Middle Name:
Last Name:FONTENOT
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 1:752 AMELIA CT
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-2089
Mailing Address - Country:US
Mailing Address - Phone:575-309-9658
Mailing Address - Fax:
Practice Address - Street 1:752 AMELIA CT
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-2089
Practice Address - Country:US
Practice Address - Phone:575-309-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114991235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist