MEDICARE: COURTNEY WARD M.A., 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
1	235Z00000X	Speech-Language Pathologist	3559	TN

General Provider Information

NPI Number	:	1154730711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY WARD M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2904 TISHOMINGO LN
Second Line	:	GUESTHOUSE
City	:	MEMPHIS
State	:	TN
Zip	:	38111-2627
Country	:	US
Telephone Number	:	609-214-9878
Fax Number	:

Provider Business Practice Location Address
First Line	:	2904 TISHOMINGO LN
Second Line	:	GUESTHOUSE
City	:	MEMPHIS
State	:	TN
Zip	:	38111-2627
Country	:	US
Telephone Number	:	609-214-9878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “ COURTNEY WARD M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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