Provider Demographics
NPI:1518150408
Name:HUTCHINSON, KATHLEEN MICHELE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MICHELE
Last Name:HUTCHINSON
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 1:10301 DEMOCRACY LN STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2545
Mailing Address - Country:US
Mailing Address - Phone:703-547-3509
Mailing Address - Fax:703-383-3887
Practice Address - Street 1:10301 DEMOCRACY LN STE 201
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-547-3509
Practice Address - Fax:703-383-3887
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7088103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist