Healthcare Provider Details
I. General information
NPI: 1235334186
Provider Name (Legal Business Name): ANNA SOMMER-CUTTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/20/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
64 MAIN ST
KEENE NH
03431-3701
US
IV. Provider business mailing address
17 93RD ST
KEENE NH
03431-3748
US
V. Phone/Fax
- Phone: 603-283-1554
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 81263595 |
| Identifier Type | MEDICAID |
| Identifier State | NH |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: