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CLYDE WILSON BUTLER MS, CCC-SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1386818318

Individual Registrant:
 CLYDE WILSON BUTLER MS, CCC-SLP
Gender: M
Not Sole Proprietor

Location and contact information for practice:
380 WOODS COVE RD  SCOTTSBORO, AL 35768-2428 US
Tel: 256-259-4840  Fax: 256-259-4830

Contact information for business:
380 WOODS COVE RD PO BOX 1050 SCOTTSBORO, AL 35768-2428 US
Tel: 256-259-4840  Fax: 256-259-4830

Registration Information:
NPI: 1386818318
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
AL2159

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE OF AL LICENSE2159AL01
BCBS515-20510AL01




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