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General NPI Number Information
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NPI Number | 1710692629
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Entity Type | Individual
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Provider Name | CLARENCE CUTSFORTH DSC.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 100 COMMONS WAY STE 250
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City | HOLMDEL
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State | NJ
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Zip | 07733-2936
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Country | US
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Telephone | 949-289-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 100 COMMONS WAY STE 250
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City | HOLMDEL
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State | NJ
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Zip | 07733-2936
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Country | US
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Telephone | 949-289-1273
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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Taxonomy #3
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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Taxonomy #5
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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