Doctor Name: | DR. GOLDIE L. KUTLER |
NPI Number: | 1124154018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD. |
License Number: | 35S100027600 |
Business Practice Address: | 76 Whiteoak Dr South Orange, NJ - 070791008 |
Business Phone Number: | 9737626678 |
Business Fax Number: | 9737626678 |
Mailing Address: | 76 Whiteoak Dr, SOUTH ORANGE |
State: | NJ |
Postal Code: | 070791008 |
Phone Number: | 9737626678 |
Fax Number: | 9737626678 |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 35S100027600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |