Healthcare Provider Details

I. General information

NPI: 1972046043
Provider Name (Legal Business Name): AMY CATHERINE HUTCHISON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2016
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 PIN OAK DR
LEXINGTON SC
29073-7916
US

IV. Provider business mailing address

460 PIN OAK DR
LEXINGTON SC
29073-7916
US

V. Phone/Fax

Practice location:
  • Phone: 803-714-3446
  • Fax: 803-824-6189
Mailing address:
  • Phone: 803-369-7584
  • Fax: 803-824-6189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: