IndividualActive
Andrea Boutwell, ST
NPI 1891815049 · Speech-Language Pathologist · Tifton, GA
Provider details
- NPI number
- 1891815049
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- ST
- Sex
- Female
- Sole proprietor
- No
- License
- SLP006592 (GA)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
901 18th St E
Tifton, GA 31794-3648
Phone: (229) 353-3347
Fax: (229) 353-7722
Street-level locationGet directions
Mailing address
901 18th St E
Tifton, GA 31794-3648
Registry dates
- Enumerated
- 2007-03-30
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.