Individual
MS. COURTNEY TANISHA COUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 AMY DR, GOOSE CREEK, SC 29445-3620
(854) 222-5502
Mailing address
350 FAIRWAY DR STE 101, DEERFIELD BEACH, FL 33441-1834
(877) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
SC
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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