Healthcare Provider Details

I. General information

NPI: 1528255643
Provider Name (Legal Business Name): BARBARA ANN HUTCHINSON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 08/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 JEFFERSON ST SW 2ND FLOOR
ROANOKE VA
24014-2419
US

IV. Provider business mailing address

447 MOTORCOACH DRIVE
POLK CITY FL
33868
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-8025
  • Fax:
Mailing address:
  • Phone: 609-675-8497
  • Fax: 877-515-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004827
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: