Healthcare Provider Details

I. General information

NPI: 1871918177
Provider Name (Legal Business Name): MS. EDITH ARUNA HUTCHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2014
Last Update Date: 02/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 NEPONSET AVE
DORCHESTER MA
02122-3168
US

IV. Provider business mailing address

415 NEPONSET AVE
DORCHESTER MA
02122-3168
US

V. Phone/Fax

Practice location:
  • Phone: 857-217-3707
  • Fax:
Mailing address:
  • Phone: 857-217-3707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number219499
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: