Provider Demographics
NPI:1033478425
Name:CUTILLO, MICHELLE ANNE
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:ANNE
Last Name:CUTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BAY ST
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4320
Mailing Address - Country:US
Mailing Address - Phone:603-569-1884
Mailing Address - Fax:
Practice Address - Street 1:70 BAY ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4320
Practice Address - Country:US
Practice Address - Phone:603-569-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health