Provider Demographics
NPI:1265601835
Name:CUTCHINS, CRYSTAL C (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:C
Last Name:CUTCHINS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:C
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:304 E. JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351
Mailing Address - Country:US
Mailing Address - Phone:850-566-5029
Mailing Address - Fax:850-807-2970
Practice Address - Street 1:304 E. JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351
Practice Address - Country:US
Practice Address - Phone:850-566-5029
Practice Address - Fax:850-807-2970
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005104235Z00000X
FLSA10757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist