Provider Demographics
NPI:1174372940
Name:DUNLAP, COURTNEY MICHELLE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MICHELLE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2322
Mailing Address - Country:US
Mailing Address - Phone:903-717-3597
Mailing Address - Fax:903-717-3597
Practice Address - Street 1:301 W 19TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2322
Practice Address - Country:US
Practice Address - Phone:903-717-3597
Practice Address - Fax:903-717-3597
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81107237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist