Provider Demographics
NPI:1104498872
Name:TUTT, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:TUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 TIVERTON PL
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2319
Mailing Address - Country:US
Mailing Address - Phone:301-661-4917
Mailing Address - Fax:
Practice Address - Street 1:1400 JERICHO PARK RD
Practice Address - Street 2:
Practice Address - City:BOWI
Practice Address - State:MD
Practice Address - Zip Code:20715
Practice Address - Country:US
Practice Address - Phone:301-661-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling