Provider Demographics
NPI:1851534275
Name:HUTCHINSON, MARY LEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LEE
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 SUGAR LEAF DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-2132
Mailing Address - Country:US
Mailing Address - Phone:770-503-1516
Mailing Address - Fax:
Practice Address - Street 1:4640 MARTIN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5533
Practice Address - Country:US
Practice Address - Phone:678-679-1261
Practice Address - Fax:678-679-1265
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist