Provider Demographics
NPI:1811398092
Name:KUTTER, KELLA (MA, MFT, CADC-I)
Entity Type:Individual
Prefix:
First Name:KELLA
Middle Name:
Last Name:KUTTER
Suffix:
Gender:F
Credentials:MA, MFT, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9492 DOUBLE R BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-6024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9492 DOUBLE R BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-6024
Practice Address - Country:US
Practice Address - Phone:775-544-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV14Medicaid