Provider Demographics
NPI:1629686126
Name:TROUTT, ANN TURNER (SLP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:TURNER
Last Name:TROUTT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 OAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-6481
Mailing Address - Country:US
Mailing Address - Phone:662-501-7968
Mailing Address - Fax:901-867-1603
Practice Address - Street 1:1751 DANCY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:HORN LAKE
Practice Address - State:MS
Practice Address - Zip Code:38637-1916
Practice Address - Country:US
Practice Address - Phone:901-292-5313
Practice Address - Fax:901-867-1603
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS4711235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist