Provider Demographics
NPI:1366422297
Name:MCCUTCHEON, MARYBETH BAKER (MS PT)
Entity type:Individual
Prefix:
First Name:MARYBETH
Middle Name:BAKER
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2101 GREENTREE RD
Mailing Address - Street 2:SUITE A116
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1453
Mailing Address - Country:US
Mailing Address - Phone:412-276-8644
Mailing Address - Fax:412-276-8648
Practice Address - Street 1:2101 GREENTREE RD
Practice Address - Street 2:SUITE A116
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1453
Practice Address - Country:US
Practice Address - Phone:412-276-8644
Practice Address - Fax:412-276-8648
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PT003248L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1326085OtherHIGHMARK
PA1326085OtherHIGHMARK