Provider Demographics
NPI:1437356292
Name:HUTCHINSON, VICKIE L (PSYCHOLOGIST PA)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:L
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:PSYCHOLOGIST PA
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:L
Other - Last Name:SVOLOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301
Mailing Address - Country:US
Mailing Address - Phone:814-677-0792
Mailing Address - Fax:814-677-0792
Practice Address - Street 1:87 STAMBAUGH AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146
Practice Address - Country:US
Practice Address - Phone:724-982-0414
Practice Address - Fax:724-982-4407
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007071L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019493640003Medicaid