Healthcare Provider Details

I. General information

NPI: 1306383187
Provider Name (Legal Business Name): JUANITA HOTCHKISS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 NORTH DR
SAUGERTIES NY
12477-4728
US

IV. Provider business mailing address

190 NORTH DR
SAUGERTIES NY
12477-4728
US

V. Phone/Fax

Practice location:
  • Phone: 845-399-5644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number096821-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: