Healthcare Provider Details

I. General information

NPI: 1720813231
Provider Name (Legal Business Name): ARIEL DAWN HUTCHEON MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 KINGSBOROUGH SQ
CHESAPEAKE VA
23320-4999
US

IV. Provider business mailing address

4000 EDINBURGH CT
SUFFOLK VA
23434-7055
US

V. Phone/Fax

Practice location:
  • Phone: 757-453-7097
  • Fax:
Mailing address:
  • Phone: 757-453-7097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704015951
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: