Healthcare Provider Details

I. General information

NPI: 1407131980
Provider Name (Legal Business Name): HARLEEN HUTCHINSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NE 4TH ST
FORT LAUDERDALE FL
33301-1151
US

IV. Provider business mailing address

401 NE 4TH ST
FORT LAUDERDALE FL
33301-1151
US

V. Phone/Fax

Practice location:
  • Phone: 954-453-6476
  • Fax:
Mailing address:
  • Phone: 954-453-6476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW2594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: