Provider Demographics
NPI:1730938549
Name:DUTKO, MARY BETH (PRE-LPC)
Entity type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:DUTKO
Suffix:
Gender:F
Credentials:PRE-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3857
Mailing Address - Country:US
Mailing Address - Phone:724-462-1936
Mailing Address - Fax:
Practice Address - Street 1:107 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3857
Practice Address - Country:US
Practice Address - Phone:724-462-1936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional