Individual
KOURTNEY DIANE LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CFY-SLP
Contact information
Practice address
9711 FARRAR CT, NORTH CHESTERFIELD, VA 23236-3679
(804) 768-7881
Mailing address
9711 FARRAR CT, NORTH CHESTERFIELD, VA 23236-3679
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000752
VA
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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