Healthcare Provider Details

I. General information

NPI: 1467612523
Provider Name (Legal Business Name): KATHRYN EMILY KUTCHINS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3974 TAMPA RD SUITE C
OLDSMAR FL
34677-3228
US

IV. Provider business mailing address

3974 TAMPA RD SUITE C
OLDSMAR FL
34677-3228
US

V. Phone/Fax

Practice location:
  • Phone: 727-692-7920
  • Fax:
Mailing address:
  • Phone: 727-692-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 9461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: