MEDICARE: AMANDA CUTTING A.T.R., L.C.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180.009619	IL

General Provider Information

NPI Number	:	1457731820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA CUTTING A.T.R., L.C.P.C.

Provider Business Mailing Address
First Line	:	1934 N WASHTENAW AVE
Second Line	:	#316
City	:	CHICAGO
State	:	IL
Zip	:	60647-4279
Country	:	US
Telephone Number	:	773-495-1844
Fax Number	:

Provider Business Practice Location Address
First Line	:	1934 N WASHTENAW AVE
Second Line	:	#316
City	:	CHICAGO
State	:	IL
Zip	:	60647-4279
Country	:	US
Telephone Number	:	773-495-1844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	06/01/2015

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