Provider Demographics
NPI:1023321163
Name:TUTHILL, SANDRA G (MS, CCC/SP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:G
Last Name:TUTHILL
Suffix:
Gender:F
Credentials:MS, CCC/SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 STARR ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-9441
Mailing Address - Country:US
Mailing Address - Phone:607-753-9052
Mailing Address - Fax:
Practice Address - Street 1:516 ELM ST.
Practice Address - Street 2:GROTON ELEMENTARY SCHOOL
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1297
Practice Address - Country:US
Practice Address - Phone:607-898-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist