Provider Demographics
NPI:1972201564
Name:CURTIN, COURTNEY BRIDGET
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BRIDGET
Last Name:CURTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 WATTERS ST NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-5487
Mailing Address - Country:US
Mailing Address - Phone:770-627-2267
Mailing Address - Fax:
Practice Address - Street 1:475 WATTERS ST NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-5487
Practice Address - Country:US
Practice Address - Phone:770-627-2267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-23-65838103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst