Provider Demographics
NPI:1194140178
Name:TUTTLE, MELISSA (PHD, LP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:
Credentials:PHD, LP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:SWARTZMILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 CHERRY ST STE 1900
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2673
Mailing Address - Country:US
Mailing Address - Phone:419-251-3878
Mailing Address - Fax:
Practice Address - Street 1:500 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2610
Practice Address - Country:US
Practice Address - Phone:419-455-8153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08392103TC2200X
MI6301016804103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0024081Medicaid
MI6301016804OtherSTATE LICENSE