MEDICARE: TORDELLIE HUTCHINSON

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
1	103K00000X	Behavior Analyst	1-25-81528	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316318827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORDELLIE HUTCHINSON

Provider Business Mailing Address
First Line	:	350 FAIRWAY DR STE 101
Second Line	:
City	:	DEERFIELD BCH
State	:	FL
Zip	:	33441-1834
Country	:	US
Telephone Number	:	877-418-2978
Fax Number	:	866-500-2186

Provider Business Practice Location Address
First Line	:	1700 NORTHSIDE DR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2673
Country	:	US
Telephone Number	:	312-972-7868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	01/01/2026

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Directions to “ TORDELLIE HUTCHINSON ” Practice Location

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