Boddie, Courtney R.

Boddie, Courtney R. is an sole proprietor health care provider with primary practice located at Southern Illinois University - Edwardsville 1 Hairpin Drive, Suite 0222, Edwardsville IL 62026-1852. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Boddie, Courtney R. can be contacted via phone (618) 401-7407.

Contact Information

Primary practice address
Southern Illinois University - Edwardsville 1 Hairpin Drive, Suite 0222 Edwardsville IL 62026-1852
Phone: (618) 401-7407
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 180012537 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2016010174 Missouri

Profile Details

NPI number 1851830442
LBN Legal business name Boddie, Courtney R.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 16th, 2017
Last updated Apr 19th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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