Healthcare Provider Details

I. General information

NPI: 1427327139
Provider Name (Legal Business Name): MARY ELLEN HUTCHESONMSED MSEDCCC-SLPNY LISSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2011
Last Update Date: 12/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD DR
SARATOGA SPRINGS NY
12866-5451
US

IV. Provider business mailing address

1 OXFORD DR
SARATOGA SPRINGS NY
12866-5451
US

V. Phone/Fax

Practice location:
  • Phone: 518-583-7784
  • Fax:
Mailing address:
  • Phone: 518-583-7784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number008730-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: