Provider Demographics
NPI:1417715848
Name:CUTRIGHT, ANGELICA NYCOLE
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:NYCOLE
Last Name:CUTRIGHT
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 1:4920 RIDER RD LOT 2
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43777-9790
Mailing Address - Country:US
Mailing Address - Phone:740-621-0593
Mailing Address - Fax:
Practice Address - Street 1:4920 RIDER RD LOT 2
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43777-9790
Practice Address - Country:US
Practice Address - Phone:740-621-0593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service