Healthcare Provider Details

I. General information

NPI: 1568792356
Provider Name (Legal Business Name): HEATHER K HUTCHISON MA, ATR-BC, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2009
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CENTURY HILL DR
LATHAM NY
12110-2116
US

IV. Provider business mailing address

812 DECAMP AVE
SCHENECTADY NY
12309-6053
US

V. Phone/Fax

Practice location:
  • Phone: 518-729-7153
  • Fax:
Mailing address:
  • Phone: 518-729-7153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001287
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number001287
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: