Healthcare Provider Details

I. General information

NPI: 1740329713
Provider Name (Legal Business Name): ALICE HUTTO M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 3RD AVE NE
HICKORY NC
28601-5014
US

IV. Provider business mailing address

106 3RD AVE NE
HICKORY NC
28601-5014
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-8736
  • Fax: 828-322-7890
Mailing address:
  • Phone: 828-322-8736
  • Fax: 828-322-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3434
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: