Provider Demographics
NPI:1285372284
Name:HUTSON, CINDY GAIL (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:GAIL
Last Name:HUTSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4804 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-5618
Mailing Address - Country:US
Mailing Address - Phone:806-239-5740
Mailing Address - Fax:
Practice Address - Street 1:5402 12TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-5406
Practice Address - Country:US
Practice Address - Phone:806-219-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist