Provider Demographics
NPI:1669739264
Name:STRATTON, CONSTANCE CUTTER (MA)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:CUTTER
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18111 NORDHOF F ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91330-8288
Mailing Address - Country:US
Mailing Address - Phone:818-677-2856
Mailing Address - Fax:
Practice Address - Street 1:18111 NORDHOF F ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91330-8288
Practice Address - Country:US
Practice Address - Phone:818-677-2856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 4378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist