Provider Demographics
NPI:1528266822
Name:KUTTER, DIANE K (BS, LCCE, FACCE)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:K
Last Name:KUTTER
Suffix:
Gender:F
Credentials:BS, LCCE, FACCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 EDSEL ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4610
Mailing Address - Country:US
Mailing Address - Phone:616-531-5274
Mailing Address - Fax:616-538-5285
Practice Address - Street 1:1206 EDSEL ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4610
Practice Address - Country:US
Practice Address - Phone:616-531-5274
Practice Address - Fax:616-538-5285
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist