Provider Demographics
NPI:1750035143
Name:LAMUTT, EVAN ELIZABETH (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:EVAN
Middle Name:ELIZABETH
Last Name:LAMUTT
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 HUFF RD NW APT 4052
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-4373
Mailing Address - Country:US
Mailing Address - Phone:404-695-5674
Mailing Address - Fax:
Practice Address - Street 1:425 WINN WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1732
Practice Address - Country:US
Practice Address - Phone:404-695-5674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist