Provider Demographics
NPI:1477792208
Name:CUTLER, KRISTIN MAUREEN (SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MAUREEN
Last Name:CUTLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N RIVER ST
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-3010
Mailing Address - Country:US
Mailing Address - Phone:360-249-4317
Mailing Address - Fax:
Practice Address - Street 1:311 N RIVER ST
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-3010
Practice Address - Country:US
Practice Address - Phone:360-249-4317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist