Healthcare Provider Details

I. General information

NPI: 1114260965
Provider Name (Legal Business Name): CHRISTINA MARIE HUTCHINS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2013
Last Update Date: 03/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E 5TH ST APT 2
BROOKLYN NY
11218-2403
US

IV. Provider business mailing address

217 E 5TH ST APT 2
BROOKLYN NY
11218-2403
US

V. Phone/Fax

Practice location:
  • Phone: 631-455-3841
  • Fax:
Mailing address:
  • Phone: 631-455-3841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number020002
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number020002
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: