Provider Demographics
NPI:1124302989
Name:CUTLER, DAVID JOHNSON (CCC/SLP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOHNSON
Last Name:CUTLER
Suffix:
Gender:M
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 LANDAU LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-3487
Mailing Address - Country:US
Mailing Address - Phone:801-651-5262
Mailing Address - Fax:
Practice Address - Street 1:10588 S REDWOOD RD
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8503
Practice Address - Country:US
Practice Address - Phone:801-651-5262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT112287-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist