Healthcare Provider Details

I. General information

NPI: 1972043040
Provider Name (Legal Business Name): HUTCHINSON PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W 2ND AVE STE E
HUTCHINSON KS
67501-5263
US

IV. Provider business mailing address

PO BOX 1221
HUTCHINSON KS
67504-1221
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-4802
  • Fax: 620-663-9867
Mailing address:
  • Phone: 620-663-4802
  • Fax: 620-663-9867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0374
License Number StateKS

VIII. Authorized Official

Name: MRS. AJ BARNES
Title or Position: OFFICE MANAGER
Credential:
Phone: 620-663-4802