Individual
MRS. COURTNEY SCOTT BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
5779 GETWELL RD, BLDG. D, SUITE 3, SOUTHAVEN, MS 38672-6347
(662) 510-6507
(662) 510-6508
Mailing address
8680 BELL RIDGE DR, OLIVE BRANCH, MS 38654-6223
(662) 895-4555
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3071
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07834592
—
MS
Enumeration date
03/21/2007
Last updated
04/26/2012
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