Provider Demographics
NPI:1497529457
Name:TUTER, MOLLY (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:TUTER
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 S PRIEST DR UNIT 12451
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-0175
Mailing Address - Country:US
Mailing Address - Phone:623-248-0283
Mailing Address - Fax:
Practice Address - Street 1:1555 RAMAR RD STE B
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-6010
Practice Address - Country:US
Practice Address - Phone:623-248-0283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18610104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker