Provider Demographics
NPI:1164789590
Name:HUTCHINSON, CHADRA DAWN (MS)
Entity Type:Individual
Prefix:MRS
First Name:CHADRA
Middle Name:DAWN
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CHADRA
Other - Middle Name:DAWN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2479 ALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2541
Mailing Address - Country:US
Mailing Address - Phone:407-271-6698
Mailing Address - Fax:
Practice Address - Street 1:2479 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-271-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator