Doctor Name: | MRS. GAIL R. MOUTON |
NPI Number: | 1346598018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SLP003041 |
Business Practice Address: | 305 Wake Forest Dr Warner Robins, GA - 310931094 |
Business Phone Number: | 4783280028 |
Business Fax Number: | |
Mailing Address: | 305 Wake Forest Dr, WARNER ROBINS |
State: | GA |
Postal Code: | 310931094 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/28/2012 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP003041 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |