Healthcare Provider Details

I. General information

NPI: 1114856739
Provider Name (Legal Business Name): MYLAN HUTCHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 BROAD ST APT 10
STEVENSON AL
35772-3248
US

IV. Provider business mailing address

706 BROAD ST APT 10
STEVENSON AL
35772-3248
US

V. Phone/Fax

Practice location:
  • Phone: 423-255-7724
  • Fax:
Mailing address:
  • Phone: 423-255-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC05985
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: