Provider Demographics
NPI:1538394465
Name:CUTNER, ELIZABETH WANICUR (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:WANICUR
Last Name:CUTNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 TOWER OAKS BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4250
Mailing Address - Country:US
Mailing Address - Phone:301-528-8575
Mailing Address - Fax:301-770-7112
Practice Address - Street 1:3204 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4250
Practice Address - Country:US
Practice Address - Phone:301-528-8575
Practice Address - Fax:301-770-7112
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3582103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist