Individual
COURTNEY L DESOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
863 HATHAWAY RD, NEW BEDFORD, MA 02740-1916
(508) 996-6763
Mailing address
35 WINTER ST, FALL RIVER, MA 02720-5017
(774) 644-1823
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
76804
MA
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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