Healthcare Provider Details

I. General information

NPI: 1205595667
Provider Name (Legal Business Name): LAURA HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SPRING ST
WHITINSVILLE MA
01588-1409
US

IV. Provider business mailing address

9 SPRING ST
WHITINSVILLE MA
01588-1409
US

V. Phone/Fax

Practice location:
  • Phone: 774-275-8542
  • Fax:
Mailing address:
  • Phone: 774-275-8542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: