Provider Demographics
NPI:1558875732
Name:HUTCHINGS, ELIZA KATHLEEN
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:KATHLEEN
Last Name:HUTCHINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3002
Mailing Address - Country:US
Mailing Address - Phone:314-541-7153
Mailing Address - Fax:
Practice Address - Street 1:1518 GRAHAM ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-3002
Practice Address - Country:US
Practice Address - Phone:314-541-7153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-26
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool