Healthcare Provider Details

I. General information

NPI: 1144864877
Provider Name (Legal Business Name): REENA ABRAHAM HUTCHINSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ALLENS CREEK RD STE 214
ROCHESTER NY
14618-3247
US

IV. Provider business mailing address

95 ALLENS CREEK RD STE 214
ROCHESTER NY
14618-3247
US

V. Phone/Fax

Practice location:
  • Phone: 585-340-7378
  • Fax:
Mailing address:
  • Phone: 585-340-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001169-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: