Provider Demographics
NPI:1457452138
Name:HUTH, CAROL M (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:HUTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MORRIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1712
Mailing Address - Country:US
Mailing Address - Phone:610-525-9494
Mailing Address - Fax:610-525-7436
Practice Address - Street 1:1124 MORRIS AVENUE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1712
Practice Address - Country:US
Practice Address - Phone:610-525-9494
Practice Address - Fax:610-525-7436
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003126L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical