Provider Demographics
NPI:1477828440
Name:HUTTO, LAURA BRISENDINE (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BRISENDINE
Last Name:HUTTO
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 KINGS CHASE RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-2160
Mailing Address - Country:US
Mailing Address - Phone:803-713-8445
Mailing Address - Fax:
Practice Address - Street 1:8 SUMMIT PL
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2401
Practice Address - Country:US
Practice Address - Phone:803-799-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist