Provider Demographics
NPI:1437629722
Name:HUTCHERSON, BEATRICE AYANNA (MSSPED)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:AYANNA
Last Name:HUTCHERSON
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CRYSTAL RUN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-7010
Mailing Address - Country:US
Mailing Address - Phone:845-692-4391
Mailing Address - Fax:
Practice Address - Street 1:4 MCKENZIE CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5069
Practice Address - Country:US
Practice Address - Phone:718-801-6267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1329059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist