Provider Demographics
NPI:1326885468
Name:STEELE, COURTNEY LATASHA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LATASHA
Last Name:STEELE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 GLENWOOD AVE SE APT 4408
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2398
Mailing Address - Country:US
Mailing Address - Phone:803-466-8878
Mailing Address - Fax:
Practice Address - Street 1:4940 GOVERNORS DR STE 205
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-2186
Practice Address - Country:US
Practice Address - Phone:770-742-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty