Provider Demographics
NPI:1275827818
Name:HUTCHINSON, RICHARD GLENN JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GLENN
Last Name:HUTCHINSON
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1786 CENTURY BLVD NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3320
Mailing Address - Country:US
Mailing Address - Phone:404-808-1678
Mailing Address - Fax:404-636-4498
Practice Address - Street 1:1786 CENTURY BLVD NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3320
Practice Address - Country:US
Practice Address - Phone:404-808-1678
Practice Address - Fax:404-636-4498
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPSY001979103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical