Provider Demographics
NPI:1982858304
Name:CUTLER, JODI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:CUTLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:807W
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:214 E 70TH ST
Practice Address - Street 2:GFF
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5425
Practice Address - Country:US
Practice Address - Phone:212-744-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014848-1235Z00000X
FLSA 10256235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist