Healthcare Provider Details

I. General information

NPI: 1780946178
Provider Name (Legal Business Name): REBECCA ERIN HUTCHINS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 W MARKET ST
AKRON OH
44303-1413
US

IV. Provider business mailing address

640 W MARKET ST
AKRON OH
44303-1413
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-5425
  • Fax:
Mailing address:
  • Phone: 330-762-5425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI1200273
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: