Healthcare Provider Details

I. General information

NPI: 1184048035
Provider Name (Legal Business Name): PAULETTE CUTUJIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13738 CAVES RD
NOVELTY OH
44072-9709
US

IV. Provider business mailing address

13738 CAVES RD
NOVELTY OH
44072-9709
US

V. Phone/Fax

Practice location:
  • Phone: 440-729-5922
  • Fax: 440-729-5924
Mailing address:
  • Phone: 440-729-5922
  • Fax: 440-729-5924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH1170136
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: