Individual
COURTNEY NICOLE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
19465 DEERFIELD AVE STE 201, LANSDOWNE, VA 20176-1703
(703) 858-7620
Mailing address
1111 ARMY NAVY DR APT 1103, ARLINGTON, VA 22202-2041
(630) 777-0472
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.014719
IL
235Z00000X
Speech-Language Pathologist
Primary
2202009321
VA
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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