Provider Demographics
NPI:1144537010
Name:ROBERT A KUTNER PSYD AND ASSOCIATES
Entity type:Organization
Organization Name:ROBERT A KUTNER PSYD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-476-1212
Mailing Address - Street 1:6628 SKY POINTE DR
Mailing Address - Street 2:STE 125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4070
Mailing Address - Country:US
Mailing Address - Phone:702-476-1212
Mailing Address - Fax:702-476-1212
Practice Address - Street 1:6628 SKY POINTE DR
Practice Address - Street 2:STE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4070
Practice Address - Country:US
Practice Address - Phone:702-476-1212
Practice Address - Fax:702-476-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0591103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty