=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609910413
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA CUTTS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2007
-----------------------------------------------------
Last Update Date | 07/17/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 123 LOGANBERRY LN
-----------------------------------------------------
City | REHOBOTH
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19971-1735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-257-2705
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 123 LOGANBERRY LANE
-----------------------------------------------------
City | REHOBOTH
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-257-2705
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | U10000911
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------