Provider Demographics
NPI:1003225996
Name:HUTCHINSON, BETH A (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-5150
Mailing Address - Country:US
Mailing Address - Phone:772-539-1134
Mailing Address - Fax:
Practice Address - Street 1:4715 KIRBY LOOP ROAD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981
Practice Address - Country:US
Practice Address - Phone:772-577-6964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OTA13808224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant