Healthcare Provider Details

I. General information

NPI: 1205475654
Provider Name (Legal Business Name): CYNTHIA BAUR HUTCHINSON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 S ORLEANS RD
BREWSTER MA
02631-2870
US

IV. Provider business mailing address

56 SILVER LEAF AVE
CHATHAM MA
02633-2441
US

V. Phone/Fax

Practice location:
  • Phone: 508-240-3500
  • Fax:
Mailing address:
  • Phone: 978-335-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number700SP-SL
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: