Provider Demographics
NPI:1750438321
Name:CUTSFORTH, QUINN (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:
Last Name:CUTSFORTH
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 1:7601 BRIANNE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3557
Mailing Address - Country:US
Mailing Address - Phone:505-417-0851
Mailing Address - Fax:505-268-0184
Practice Address - Street 1:4210A LOUISIANA BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1807
Practice Address - Country:US
Practice Address - Phone:505-268-5933
Practice Address - Fax:505-268-0184
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3665235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist