Individual
CLYDE WILSON BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
380 WOODS COVE RD, SCOTTSBORO, AL 35768-2428
(256) 259-4840
(256) 259-4830
Mailing address
380 WOODS COVE RD, PO BOX 1050, SCOTTSBORO, AL 35768-2428
(256) 259-4840
(256) 259-4830
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2159
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159
STATE OF AL LICENSE
AL
01
—
515-20510
BCBS
AL
Enumeration date
04/22/2008
Last updated
04/22/2008
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