Healthcare Provider Details

I. General information

NPI: 1568258101
Provider Name (Legal Business Name): ANNE HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELLY HUTCHINSON

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 RIVER RUN DR
PROVO UT
84604-7726
US

IV. Provider business mailing address

5455 RIVER RUN DR
PROVO UT
84604-7726
US

V. Phone/Fax

Practice location:
  • Phone: 801-226-2550
  • Fax:
Mailing address:
  • Phone: 801-763-7315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12158279-2506
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA1-25-83619
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: