Provider Demographics
NPI:1760554109
Name:CUTIE, KATHLEEN (OTR L)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:CUTIE
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17796 ROUND O RD
Mailing Address - Street 2:
Mailing Address - City:ROUND O
Mailing Address - State:SC
Mailing Address - Zip Code:29474-3420
Mailing Address - Country:US
Mailing Address - Phone:843-607-3866
Mailing Address - Fax:843-538-7326
Practice Address - Street 1:103 3RD ST E
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924-2511
Practice Address - Country:US
Practice Address - Phone:803-943-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC432225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC426607Medicare ID - Type Unspecified