Healthcare Provider Details

I. General information

NPI: 1962631895
Provider Name (Legal Business Name): ANNIE B. HUTT L.P.C,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 WASHINGTON AVE STE 220
GOLDEN CO
80401-1162
US

IV. Provider business mailing address

3029 OLYMPIA CIR
EVERGREEN CO
80439-8833
US

V. Phone/Fax

Practice location:
  • Phone: 303-349-2619
  • Fax:
Mailing address:
  • Phone: 303-349-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4893
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: