Basic Information
| Provider Information | |||||||||
| NPI: | 1851451652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REID ALEXANDER | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | MACCCSLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11786 FREEDOM DR | ||||||||
| Address2: | |||||||||
| City: | WHITMORE LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481899176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346462497 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11060 HI TECH DR | ||||||||
| Address2: | LEAPS AND BOUNDS THERAPY SERVICES | ||||||||
| City: | WHITMORE LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481899133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344494649 | ||||||||
| FaxNumber: | 7344494667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.