Provider Demographics
NPI:1184337586
Name:HUOT, LEVI JOSEPH (SLPA)
Entity type:Individual
Prefix:
First Name:LEVI
Middle Name:JOSEPH
Last Name:HUOT
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5148 N WESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-4250
Mailing Address - Country:US
Mailing Address - Phone:928-713-9987
Mailing Address - Fax:
Practice Address - Street 1:3160 STILLWATER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7151
Practice Address - Country:US
Practice Address - Phone:928-776-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP12501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist