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NPI Code Detail

MEDICARE: MRS. COURTNEY PAULINE KOHARCHICK MA CCC-SLP

MEDICARE: MRS. COURTNEY PAULINE KOHARCHICK MA 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 Pathologist46001737AIN
2235Z00000XSpeech-Language Pathologist22004740AIN

General Provider Information

NPI Number : 1417113598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COURTNEY PAULINE KOHARCHICK MA CCC-SLP
Provider Business Mailing Address
First Line : 2297 SOUTHWARD DR
Second Line : GREENWOOD
City : GREENWOOD
State : IN
Zip : 46143-3421
Country : US
Telephone Number : 574-329-2310
Fax Number :
Provider Business Practice Location Address
First Line : 302 N JOHNSON RD
Second Line : MOORESVILLE
City : MOORESVILLE
State : IN
Zip : 46158-5504
Country : US
Telephone Number : 317-831-9033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2008
Last Update Date : 07/30/2008

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Directions to “ MRS. COURTNEY PAULINE KOHARCHICK MA CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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