Healthcare Provider Details

I. General information

NPI: 1669360129
Provider Name (Legal Business Name): CAROLINE HUTCHINSON QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7813 N DIXIE DR
DAYTON OH
45414-2719
US

IV. Provider business mailing address

912 WESTWOOD AVE
DAYTON OH
45402-5343
US

V. Phone/Fax

Practice location:
  • Phone: 937-677-7522
  • Fax:
Mailing address:
  • Phone: 937-677-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: