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NPI Code Detail

MEDICARE: CARMEN QUEZADA HUTSON LCSW

MEDICARE: CARMEN QUEZADA HUTSON LCSW
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
11041C0700XClinical Social WorkerCSW002929GA

General Provider Information

NPI Number : 1083957567
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN QUEZADA HUTSON LCSW
Provider Business Mailing Address
First Line : 3131 MOUNTAIN CREEK RD APT 4A2
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37415-7217
Country : US
Telephone Number : 818-238-5599
Fax Number :
Provider Business Practice Location Address
First Line : 487 MORRISON MOORE PKWY W
Second Line :
City : DAHLONEGA
State : GA
Zip : 30533-1422
Country : US
Telephone Number : 404-644-8967
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 04/03/2013

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Directions to “ CARMEN QUEZADA HUTSON LCSW” Practice Location

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