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General NPI Number Information
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NPI Number | 1427611292
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Entity Type | Individual
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Provider Name | ELIZABETH HUTCHINSON CDCA
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Gender | Female
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 511 PERRY ST
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City | DEFIANCE
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State | OH
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Zip | 43512-2123
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Country | US
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Telephone | 419-782-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 7856 STATE ROUTE 108 LOT 32
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City | WAUSEON
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State | OH
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Zip | 43567-9273
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Country | US
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Telephone | 419-410-3099
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CDCA.170171
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License Number State | OH
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