Provider Demographics
NPI:1477731065
Name:CUTLER, LESLIE PROULX (LMCH)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:PROULX
Last Name:CUTLER
Suffix:
Gender:F
Credentials:LMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SCHOOSETT ST
Mailing Address - Street 2:RTE. 139
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1821
Mailing Address - Country:US
Mailing Address - Phone:781-826-9700
Mailing Address - Fax:
Practice Address - Street 1:43 SCHOOSETT ST
Practice Address - Street 2:RTE. 139
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1821
Practice Address - Country:US
Practice Address - Phone:781-826-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health