Healthcare Provider Details

I. General information

NPI: 1013307545
Provider Name (Legal Business Name): KAREN HUTCHESON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 PARK PLAZA AVE UNIT 103
LOUISVILLE KY
40241-2289
US

IV. Provider business mailing address

3317 NANZ AVE
LOUISVILLE KY
40207-3605
US

V. Phone/Fax

Practice location:
  • Phone: 502-339-2442
  • Fax:
Mailing address:
  • Phone: 502-338-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1597
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: