Provider Demographics
NPI:1710088927
Name:HUTCHISON, KRISTINE ANN (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANN
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:ANN
Other - Last Name:HUIET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4055 EXECUTIVE PARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-4019
Mailing Address - Country:US
Mailing Address - Phone:513-469-6226
Mailing Address - Fax:513-469-6277
Practice Address - Street 1:4055 EXECUTIVE PARK DR STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4019
Practice Address - Country:US
Practice Address - Phone:513-469-6226
Practice Address - Fax:513-469-6277
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical