Healthcare Provider Details

I. General information

NPI: 1992918924
Provider Name (Legal Business Name): SCOTT VERNON CUTLER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 S MAIN ST
CENTERVILLE UT
84014-2206
US

IV. Provider business mailing address

1643 E 2700 N
LAYTON UT
84040-8578
US

V. Phone/Fax

Practice location:
  • Phone: 801-292-2404
  • Fax:
Mailing address:
  • Phone: 801-771-8381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number345124-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: