Provider Demographics
NPI:1679064166
Name:FLOYD, COURTNEY MADISON (SLP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MADISON
Last Name:FLOYD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4153 FLAT SHOALS PKWY # 300A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-4106
Mailing Address - Country:US
Mailing Address - Phone:404-244-9477
Mailing Address - Fax:
Practice Address - Street 1:4153 FLAT SHOALS PKWY # 300A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4106
Practice Address - Country:US
Practice Address - Phone:404-244-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPCET002599OtherSTATE LICENSE