Boutwell, Andrea
Boutwell, Andrea is an individual health care provider with primary practice located at 901 18Th St E , Tifton GA 31794-3648. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Boutwell, Andrea can be contacted via phone (229) 353-3347.Contact Information
Primary practice address
901 18Th St E
Tifton GA 31794-3648
Phone: (229) 353-3347
Fax: (229) 353-7722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP006592 | Georgia |
Profile Details
| NPI number | 1891815049 |
|---|---|
| LBN Legal business name | Boutwell, Andrea |
| Credentials | Surgical Technician (ST) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891815049 | NPPES |
| Georgia | Other | SLP006592 | LICENSE NUMBER |
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