Healthcare Provider Details

I. General information

NPI: 1649325093
Provider Name (Legal Business Name): HAROLD MEADE HUTCHISON D.MIN.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E 5TH ST SUITE 102
CHARLOTTE NC
28204-2379
US

IV. Provider business mailing address

1801 E 5TH ST SUITE 102
CHARLOTTE NC
28204-2379
US

V. Phone/Fax

Practice location:
  • Phone: 704-375-3032
  • Fax:
Mailing address:
  • Phone: 704-375-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number532
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: