| Doctor Name: | MS. COURTNEY B HENRY |
| NPI Number: | 1790081719 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC SLP |
| License Number: | 7415 |
| Business Practice Address: | 1400 Vfw Pkwy West Roxbury, MA - 021324927 |
| Business Phone Number: | 8572036771 |
| Business Fax Number: | |
| Mailing Address: | 35 Mystic St, Apt. 2 CHARLESTOWN |
| State: | MA |
| Postal Code: | 021291915 |
| Phone Number: | 8572036771 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2011 |
| NPI Last Update Date: | 02/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 7415 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| 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 |