Healthcare Provider Details

I. General information

NPI: 1528231495
Provider Name (Legal Business Name): ANN HUTCHESON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN BLALOCK PSYD

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19927 UNIMAK CIR
EAGLE RIVER AK
99577-8713
US

IV. Provider business mailing address

19927 UNIMAK CIR
EAGLE RIVER AK
99577-8713
US

V. Phone/Fax

Practice location:
  • Phone: 907-242-8456
  • Fax:
Mailing address:
  • Phone: 907-242-8456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number241492
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: