# NORTHERN TIDES SPEECH AND LANGUAGE L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750788410
- **Authorized official:** MR. STEPHEN A CUTIA M.S. CCC-SLP (SPEECH AND LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (607) 423-6613

## Contact information

- **Practice address:** 1744 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4935
- **Practice address phone:** (607) 423-6613
- **Practice address fax:** (843) 375-6177
- **Mailing address:** 1329 NATIONAL DR, MT PLEASANT, SC 29466-8979
- **Mailing address phone:** (843) 708-9138
- **Mailing address fax:** (843) 375-6177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | 4986 | SC | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 11/24/2014
- **Last updated:** 02/08/2023