Provider Demographics
NPI:1831645530
Name:HUTCHINSON, CEARA (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:CEARA
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 KENDALL ST
Mailing Address - Street 2:APT 17
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1700
Mailing Address - Country:US
Mailing Address - Phone:207-227-6399
Mailing Address - Fax:
Practice Address - Street 1:7 GILLMAN STREET
Practice Address - Street 2:BOX 332
Practice Address - City:MARS HILL
Practice Address - State:ME
Practice Address - Zip Code:04758-0332
Practice Address - Country:US
Practice Address - Phone:207-227-6399
Practice Address - Fax:207-532-4718
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST2565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist