Basic Information
| Provider Information | |||||||||
| NPI: | 1831645530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUTCHINSON | ||||||||
| FirstName: | CEARA | ||||||||
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| Credential: | MA, CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 KENDALL ST | ||||||||
| Address2: | APT 17 | ||||||||
| City: | HOULTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047301700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072276399 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 GILLMAN STREET | ||||||||
| Address2: | BOX 332 | ||||||||
| City: | MARS HILL | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047580332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072276399 | ||||||||
| FaxNumber: | 2075324718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | ST2565 | ME | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.