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General NPI Number Information
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NPI Number | 1578658050
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Entity Type | Individual
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Provider Name | GLEN ART SUTCH M.S. (LMFT)
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 49774 ROAD 426 STE D
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City | OAKHURST
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State | CA
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Zip | 93644-8691
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Country | US
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Telephone | 559-683-4809
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Fax | 559-683-6499
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Provider Business Mailing Address
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Address Line | PO BOX 701
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City | COARSEGOLD
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State | CA
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Zip | 93614-0701
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Country | US
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Telephone | 714-394-3332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT 77143
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License Number State | CA
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