Healthcare Provider Details

I. General information

NPI: 1326816406
Provider Name (Legal Business Name): CASONYA L HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 MAIN ST
EAST HARTFORD CT
06118-3239
US

IV. Provider business mailing address

60 PRATT ST
EAST HARTFORD CT
06118-1529
US

V. Phone/Fax

Practice location:
  • Phone: 860-362-0225
  • Fax:
Mailing address:
  • Phone: 860-709-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: