Provider Demographics
NPI:1841424280
Name:HUTTON, LAURA LOUISE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LOUISE
Last Name:HUTTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 WOODLAND PL APT 3
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2425
Mailing Address - Country:US
Mailing Address - Phone:508-737-9224
Mailing Address - Fax:
Practice Address - Street 1:645 WOODLAND PL APT 3
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2425
Practice Address - Country:US
Practice Address - Phone:508-737-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist