Provider Demographics
NPI:1770571499
Name:KUTCH, SCARLETT G (BBA)
Entity type:Individual
Prefix:MRS
First Name:SCARLETT
Middle Name:G
Last Name:KUTCH
Suffix:
Gender:F
Credentials:BBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 E WEBBER DR
Mailing Address - Street 2:MAIL ONLY
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9419
Mailing Address - Country:US
Mailing Address - Phone:713-419-3217
Mailing Address - Fax:832-295-9336
Practice Address - Street 1:3114 E WEBBER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9419
Practice Address - Country:US
Practice Address - Phone:713-419-3217
Practice Address - Fax:832-295-9336
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS00527OtherTRAILBLAZEREDISUBMITTERID