Provider Demographics
NPI:1285026971
Name:LUTHER, COURTNEY M (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:M
Last Name:LUTHER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:M
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3228 POPLAR HILL RD.
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14487
Mailing Address - Country:US
Mailing Address - Phone:585-281-7379
Mailing Address - Fax:
Practice Address - Street 1:5871 GROVELAND STATION RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510
Practice Address - Country:US
Practice Address - Phone:585-658-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-04
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY024530OtherOFFICE OF PROFESSIONS NYSED