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General NPI Number Information
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NPI Number | 1730987330
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Entity Type | Individual
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Provider Name | SAMANTHA ANN OUTHOUSE SLPA
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 11820 DENTON AVE
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City | HUDSON
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State | FL
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Zip | 34667-5419
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Country | US
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Telephone | 845-898-0616
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Fax |
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Provider Business Mailing Address
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Address Line | 11792 CASA LAGO LN APT 304
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City | TAMPA
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State | FL
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Zip | 33626-1644
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Country | US
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Telephone | 845-898-0616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI7766
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License Number State | FL
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