Provider Demographics
NPI:1700438520
Name:LEBARRON, COURTNEY RAE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:LEBARRON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5549 CAMEO DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-6352
Mailing Address - Country:US
Mailing Address - Phone:812-319-8584
Mailing Address - Fax:
Practice Address - Street 1:5549 CAMEO DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-6352
Practice Address - Country:US
Practice Address - Phone:812-319-8584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46003550A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist