| Doctor Name: | MRS. COLLEEN RENEE KOURAKOS |
| NPI Number: | 1770892721 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A.CCC/SLP |
| License Number: | 006084-1 |
| Business Practice Address: | 222 Seven Bridges Road Chappaqua, NY - 105140022 |
| Business Phone Number: | 9146667330 |
| Business Fax Number: | |
| Mailing Address: | Po Box 22 222 Seven Bridges Road, CHAPPAQUA |
| State: | NY |
| Postal Code: | 105140022 |
| Phone Number: | 9146667330 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2010 |
| NPI Last Update Date: | 09/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 006084-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| 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 |