Provider Demographics
NPI:1205175627
Name:L.A.S.T.S. LLC
Entity type:Organization
Organization Name:L.A.S.T.S. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MOUTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:281-719-5060
Mailing Address - Street 1:2109 SAWDUST RD
Mailing Address - Street 2:APT31102
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1733
Mailing Address - Country:US
Mailing Address - Phone:281-719-5060
Mailing Address - Fax:281-719-5962
Practice Address - Street 1:1544 SAWDUST RD
Practice Address - Street 2:STE 105
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2929
Practice Address - Country:US
Practice Address - Phone:281-719-5060
Practice Address - Fax:281-719-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty