| Doctor Name: | COURTNEY BULL |
| NPI Number: | 1699183186 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | TSLP-2596 |
| Business Practice Address: | 245 N 3rd E Mountain Home, ID - 836472734 |
| Business Phone Number: | 2085878255 |
| Business Fax Number: | 2085874475 |
| Mailing Address: | 245 N 3rd E, MOUNTAIN HOME |
| State: | ID |
| Postal Code: | 836472734 |
| Phone Number: | 2085878255 |
| Fax Number: | 2085874475 |
| NPI Enumeration Date: | 07/28/2014 |
| NPI Last Update Date: | 07/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | TSLP-2596 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |