Provider Demographics
NPI:1487397204
Name:LEPPEK, COURTNEY (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:
Last Name:LEPPEK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 HILLS RD
Mailing Address - Street 2:
Mailing Address - City:BARODA
Mailing Address - State:MI
Mailing Address - Zip Code:49101-9760
Mailing Address - Country:US
Mailing Address - Phone:269-231-0602
Mailing Address - Fax:
Practice Address - Street 1:2528 BYPASS RD
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1528
Practice Address - Country:US
Practice Address - Phone:269-231-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN14381992235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist