MEDICARE: MS. RONNI CUTLER LCSW, CAP

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	1041C0700X	Clinical Social Worker	SW4205	FL

General Provider Information

NPI Number	:	1649229626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RONNI CUTLER LCSW, CAP

Provider Business Mailing Address
First Line	:	1100 SAND DRIFT WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-1852
Country	:	US
Telephone Number	:	561-684-1991
Fax Number	:	561-828-9272

Provider Business Practice Location Address
First Line	:	5887 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3209
Country	:	US
Telephone Number	:	561-965-8699
Fax Number	:	561-967-2113

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	10/28/2010

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