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NPI Code Detail

MEDICARE: KORTNEY PRATER SLP-CCC

MEDICARE: KORTNEY PRATER SLP-CCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist106330TX

General Provider Information

NPI Number : 1023378619
Entity Type Code : Individual
Provider Name (Legal Business Name) : KORTNEY PRATER SLP-CCC
Provider Business Mailing Address
First Line : 606 MIKES BR
Second Line :
City : PIKEVILLE
State : KY
Zip : 41501-6433
Country : US
Telephone Number : 606-434-7290
Fax Number :
Provider Business Practice Location Address
First Line : 871 OLD ALICE RD STE 600
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78520-8274
Country : US
Telephone Number : 956-541-2102
Fax Number : 956-541-2502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2012
Last Update Date : 09/26/2013

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Directions to “ KORTNEY PRATER SLP-CCC” Practice Location

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