Basic Information
| Provider Information | |||||||||
| NPI: | 1750463576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUTCHINSON | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | DIANNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 HIDALGO DRIVE | ||||||||
| Address2: | |||||||||
| City: | RAEFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283765978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109076999 | ||||||||
| FaxNumber: | 9109076571 | ||||||||
| Practice Location | |||||||||
| Address1: | 2817 REILLY ROAD MCXC- DSWS | ||||||||
| Address2: | WOMACK ARMY MEDICAL CENTER | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283107301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109076999 | ||||||||
| FaxNumber: | 9109076571 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 08/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C004620 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.