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General NPI Number Information
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NPI Number | 1780229542
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Entity Type | Individual
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Provider Name | DESEREE NICOLE HUTSON
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Gender | Female
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 2326 GODDARD PKWY STE D
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City | SALISBURY
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State | MD
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Zip | 21801-1126
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Country | US
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Telephone | 443-978-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 209 WALNUT ST
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City | POCOMOKE CITY
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State | MD
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Zip | 21851-1423
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Country | US
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Telephone | 240-329-1936
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA1423
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License Number State | MD
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