Healthcare Provider Details

I. General information

NPI: 1124528203
Provider Name (Legal Business Name): CLAIRE HUTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 WAR BONNET WAY
INCLINE VILLAGE NV
89451-9216
US

IV. Provider business mailing address

1054 WAR BONNET WAY
INCLINE VILLAGE NV
89451-9216
US

V. Phone/Fax

Practice location:
  • Phone: 513-309-3905
  • Fax: 650-560-2530
Mailing address:
  • Phone: 513-309-3905
  • Fax: 650-560-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18-1016
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: