=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083231187
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGEL M CUTCHER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2020
-----------------------------------------------------
Last Update Date | 07/06/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 E SEMINARY ST
-----------------------------------------------------
City | NORWALK
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44857-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-424-6003
-----------------------------------------------------
Fax | 855-429-4118
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3764 US HIGHWAY 224 E LOT 3
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44837-9300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-908-3798
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------