Healthcare Provider Details

I. General information

NPI: 1235899980
Provider Name (Legal Business Name): MARY E HUTCHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY E TOWNSEND

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 30TH ST
JOPLIN MO
64804-1520
US

IV. Provider business mailing address

PO BOX 2526
JOPLIN MO
64803-2526
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-7580
  • Fax:
Mailing address:
  • Phone: 417-347-7579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024009308
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: