Healthcare Provider Details

I. General information

NPI: 1104214139
Provider Name (Legal Business Name): MICHAEL STUART HUTTON-WOODLAND PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2014
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N MAIN ST
SUNDERLAND MA
01375-9502
US

IV. Provider business mailing address

67 HULST RD
AMHERST MA
01002-3534
US

V. Phone/Fax

Practice location:
  • Phone: 413-665-8717
  • Fax: 413-665-9383
Mailing address:
  • Phone: 413-320-7773
  • Fax: 413-665-9383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: