Provider Demographics
NPI:1558951681
Name:HUTSON, SARAH MCKENZIE (MA, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MCKENZIE
Last Name:HUTSON
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CROWLEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63780-9124
Mailing Address - Country:US
Mailing Address - Phone:573-318-5733
Mailing Address - Fax:
Practice Address - Street 1:614 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-2150
Practice Address - Country:US
Practice Address - Phone:573-243-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022035209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty