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
Fax: (229) 353-7722
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1891815049 NPPES
Georgia Other SLP006592 LICENSE NUMBER

Popular Providers