MEDICARE: MICHELLE CUTHBERTSON

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	101Y00000X	Counselor	NLC.0004693	CO
2	374K00000X	Religious Nonmedical Practitioner

General Provider Information

NPI Number	:	1972092658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE CUTHBERTSON

Provider Business Mailing Address
First Line	:	1070 W CENTURY DR STE 200
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-1657
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 W CENTURY DR STE 200
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-1657
Country	:	US
Telephone Number	:	303-905-0823
Fax Number	:

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

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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Directions to “ MICHELLE CUTHBERTSON ” Practice Location

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