Individual
MR. MICHAEL J LUTTRELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LICENSED PSYCHOLOGIS
Contact information
Practice address
9 N 4TH AVE, MARSHALLTOWN, IA 50158-1836
(641) 752-1585
(641) 752-9665
Mailing address
508 BRENTWOOD RD, MARSHALLTOWN, IA 50158-3726
(641) 752-0125
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
00420
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058230
—
IA
01
—
037093
HEALTH ALLIANCE
IA
01
—
05823
BCBS
IA
Enumeration date
02/15/2006
Last updated
07/08/2007
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