Healthcare Provider Details

I. General information

NPI: 1528293743
Provider Name (Legal Business Name): EMILY HUTTO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

956 MONTCLAIR RD SUITE 200
BIRMINGHAM AL
35213-1218
US

IV. Provider business mailing address

200 CHASE PARK S STE 102
HOOVER AL
35244-1884
US

V. Phone/Fax

Practice location:
  • Phone: 205-949-4540
  • Fax:
Mailing address:
  • Phone: 205-994-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2207C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: