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General NPI Number Information
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NPI Number | 1013392869
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Entity Type | Individual
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Provider Name | KIMBERLY S HUTCHINSON PHD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 710 OAKFIELD DR STE 252
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City | BRANDON
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State | FL
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Zip | 33511-4924
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Country | US
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Telephone | 239-295-6564
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Fax | 888-801-3850
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Provider Business Mailing Address
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Address Line | PO BOX 100166
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City | CAPE CORAL
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State | FL
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Zip | 33910-0166
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Country | US
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Telephone | 239-295-6564
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Fax | 888-801-3850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1330
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9204
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY9204
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9204
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 9204
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1330
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License Number State | LA
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Taxonomy #7
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 1330
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License Number State | LA
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Taxonomy #8
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PY9204
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1330
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License Number State | LA
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