Doctor Name: | MR. TERRENCE ROBERT BUTLER |
NPI Number: | 1831305358 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS-CCC-SLP |
License Number: | SA272 |
Business Practice Address: | 622 Kings Ln Sw Winter Haven, FL - 338801713 |
Business Phone Number: | 8632070201 |
Business Fax Number: | 8632945220 |
Mailing Address: | 622 Kings Ln Sw, WINTER HAVEN |
State: | FL |
Postal Code: | 338801713 |
Phone Number: | 8632070201 |
Fax Number: | 8632945220 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA272 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |