Healthcare Provider Details

I. General information

NPI: 1306583463
Provider Name (Legal Business Name): ELEANOR HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 STRADER DR
LEXINGTON KY
40505-4088
US

IV. Provider business mailing address

525 ANGLIANA AVE
LEXINGTON KY
40508-3324
US

V. Phone/Fax

Practice location:
  • Phone: 859-899-9200
  • Fax:
Mailing address:
  • Phone: 606-875-3884
  • 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: