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NPI Code Detail

MEDICARE: LORENE R HEUVELMAN-HUTCHINSON MS, EDS, PSYD

MEDICARE:   LORENE R HEUVELMAN-HUTCHINSON  MS, EDS, PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist4673SC
2101YP2500XProfessional Counselor6802SC

General Provider Information

NPI Number : 1720583859
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORENE R HEUVELMAN-HUTCHINSON MS, EDS, PSYD
Provider Business Mailing Address
First Line : 419 SE MAIN ST STE 203A
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-2673
Country : US
Telephone Number : 678-230-0476
Fax Number :
Provider Business Practice Location Address
First Line : 419 SE MAIN ST STE 203A
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-2673
Country : US
Telephone Number : 678-230-0476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2018
Last Update Date : 06/14/2023

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Directions to “ LORENE R HEUVELMAN-HUTCHINSON MS, EDS, PSYD” Practice Location

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