Provider Demographics
NPI:1932679453
Name:FABRY, COURTNEY GARLAND (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:GARLAND
Last Name:FABRY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:GARLAND
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 NEENAH CTR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3070
Mailing Address - Country:US
Mailing Address - Phone:920-454-2973
Mailing Address - Fax:920-720-7350
Practice Address - Street 1:1818 N MEADE ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3454
Practice Address - Country:US
Practice Address - Phone:920-454-2973
Practice Address - Fax:920-720-7350
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005673235Z00000X
WI4521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist