Provider Demographics
NPI:1598980922
Name:CUTTLER, MICHAEL JEFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEFFREY
Last Name:CUTTLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7728
Mailing Address - Country:US
Mailing Address - Phone:336-852-6902
Mailing Address - Fax:336-299-0110
Practice Address - Street 1:604 GREEN VALLEY RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7728
Practice Address - Country:US
Practice Address - Phone:336-852-6902
Practice Address - Fax:336-299-0110
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC461103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical