Provider Demographics
NPI:1093763278
Name:STOOT, CAROL M (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:M
Last Name:STOOT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86315
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70879-6315
Mailing Address - Country:US
Mailing Address - Phone:225-925-5060
Mailing Address - Fax:225-925-5061
Practice Address - Street 1:4550 NORTH BLVD., SUITE 203
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-925-5060
Practice Address - Fax:225-925-5061
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist