Individual
LAUREN MARIE CLUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 S BROADWAY ST, LODI, OH 44254-1328
(330) 461-2887
Mailing address
210 S BROADWAY ST, LODI, OH 44254-1328
(330) 461-2887
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5213850
—
OH
Enumeration date
12/30/2020
Last updated
12/30/2020
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