Provider Demographics
NPI:1063628162
Name:TOUT, MICHELLE WATERS (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:WATERS
Last Name:TOUT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 STRAWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-8241
Mailing Address - Country:US
Mailing Address - Phone:205-616-6216
Mailing Address - Fax:205-941-9313
Practice Address - Street 1:1917 STRAWBERRY LN
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-8241
Practice Address - Country:US
Practice Address - Phone:205-616-6216
Practice Address - Fax:205-941-0313
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000517-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist