Healthcare Provider Details

I. General information

NPI: 1629112487
Provider Name (Legal Business Name): MARILYN A HUTCHINSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W GREGORY BLVD SUITE 100
KANSAS CITY MO
64114-1140
US

IV. Provider business mailing address

222 W GREGORY BLVD SUITE 100
KANSAS CITY MO
64114-1140
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0664
  • Fax: 816-361-0677
Mailing address:
  • Phone: 816-361-0664
  • Fax: 816-361-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPYR0110
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: