Doctor Name: | DR. SUSAN TUTTLE |
NPI Number: | 1053482786 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., MFT |
License Number: | MFT17144 |
Business Practice Address: | 2345 Erringer Rd Suite 209 Simi Valley, CA - 930652235 |
Business Phone Number: | 8055841732 |
Business Fax Number: | 8055848368 |
Mailing Address: | 2345 Erringer Rd, Suite 209 SIMI VALLEY |
State: | CA |
Postal Code: | 930652235 |
Phone Number: | 8055841732 |
Fax Number: | 8055848368 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MFT17144 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |