Provider Demographics
NPI:1861788333
Name:MUTTER, EMILY L (AUD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:MUTTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ROBIN AVE
Mailing Address - Street 2:STE. 4
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5772
Mailing Address - Country:US
Mailing Address - Phone:985-230-6160
Mailing Address - Fax:
Practice Address - Street 1:2101 ROBIN AVE
Practice Address - Street 2:STE. 4
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5772
Practice Address - Country:US
Practice Address - Phone:985-230-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6466237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter