Provider Demographics
NPI:1306218433
Name:CHERYL HUTHER INC
Entity Type:Organization
Organization Name:CHERYL HUTHER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTHER
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:518-248-0904
Mailing Address - Street 1:6424 N MANLIUS RD
Mailing Address - Street 2:
Mailing Address - City:KIRKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13082-9739
Mailing Address - Country:US
Mailing Address - Phone:518-248-0904
Mailing Address - Fax:
Practice Address - Street 1:6424 N MANLIUS RD
Practice Address - Street 2:
Practice Address - City:KIRKVILLE
Practice Address - State:NY
Practice Address - Zip Code:13082-9739
Practice Address - Country:US
Practice Address - Phone:315-656-8813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017843-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03336183Medicaid