Provider Demographics
NPI:1811239841
Name:CUTSINGER, CHERYL BOWEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:BOWEN
Last Name:CUTSINGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 COLINBROOK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143
Mailing Address - Country:US
Mailing Address - Phone:815-501-3284
Mailing Address - Fax:
Practice Address - Street 1:325 W ELIAN CT
Practice Address - Street 2:
Practice Address - City:MAPLE PARK
Practice Address - State:IL
Practice Address - Zip Code:60151-7621
Practice Address - Country:US
Practice Address - Phone:815-501-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008805235Z00000X
IN22006088A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist