Provider Demographics
NPI:1588179659
Name:STOOT SPEECH LANGUAGE SERVICES
Entity Type:Organization
Organization Name:STOOT SPEECH LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:STOOT
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:334-781-8699
Mailing Address - Street 1:5760 CARMICHAEL PKWY STE 9
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2333
Mailing Address - Country:US
Mailing Address - Phone:334-781-8699
Mailing Address - Fax:334-277-2919
Practice Address - Street 1:5760 CARMICHAEL PKWY STE 9
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2333
Practice Address - Country:US
Practice Address - Phone:334-781-8699
Practice Address - Fax:334-277-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty