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NPI Code Detail

MEDICARE: SUE HUTCHINS LADAC

MEDICARE:   SUE  HUTCHINS  LADAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor0105961NM

General Provider Information

NPI Number : 1083804744
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE HUTCHINS LADAC
Provider Business Mailing Address
First Line : 902 W ALABAMA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-4604
Country : US
Telephone Number : 505-526-9002
Fax Number : 505-526-9110
Provider Business Practice Location Address
First Line : 125 WYATT DR
Second Line : B
City : LAS CRUCES
State : NM
Zip : 88005-2924
Country : US
Telephone Number : 505-526-9002
Fax Number : 505-526-9110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2007
Last Update Date : 07/30/2007

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Directions to “ SUE HUTCHINS LADAC” Practice Location

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