Healthcare Provider Details

I. General information

NPI: 1568377224
Provider Name (Legal Business Name): STEPHANIE HUTCHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH ST STE B
CLEVELAND MS
38732-2765
US

IV. Provider business mailing address

127 NORTH ST STE B
CLEVELAND MS
38732-2765
US

V. Phone/Fax

Practice location:
  • Phone: 662-580-4410
  • Fax: 662-450-3174
Mailing address:
  • Phone: 662-580-4410
  • Fax: 662-450-3174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS0830
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: