Provider Demographics
NPI:1588122741
Name:COURTNEY, BRITNEE GOLDMAN (MSP CCC SLP)
Entity type:Individual
Prefix:
First Name:BRITNEE
Middle Name:GOLDMAN
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:MSP CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-1823
Mailing Address - Country:US
Mailing Address - Phone:803-507-3981
Mailing Address - Fax:
Practice Address - Street 1:1877 N PARIS AVE
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2029
Practice Address - Country:US
Practice Address - Phone:803-507-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist