Provider Demographics
NPI:1801382122
Name:MCKENZIE, COURTNEY (AUD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1728
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1102 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1728
Practice Address - Country:US
Practice Address - Phone:512-462-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2025-12-04
Deactivation Date:2022-08-25
Deactivation Code:
Reactivation Date:2025-12-04
Provider Licenses
StateLicense IDTaxonomies
TX80894231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist