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NPI Code Detail

MEDICARE: COURTNEY MARIE JACKSON M.S., CCC-SLP

MEDICARE: COURTNEY MARIE JACKSON M.S., CCC-SLP
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 PathologistSLP009732GA

General Provider Information

NPI Number : 1629598099
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY MARIE JACKSON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 7600 CHEVY CHASE DR STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78752-1599
Country : US
Telephone Number : 615-668-2593
Fax Number :
Provider Business Practice Location Address
First Line : 7600 CHEVY CHASE DR STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78752-1599
Country : US
Telephone Number : 615-668-2593
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2017
Last Update Date : 04/07/2026

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Directions to “ COURTNEY MARIE JACKSON M.S., CCC-SLP” Practice Location

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