Provider Demographics
NPI:1740565316
Name:HUTTER, JEANETTE CATHERINE (BS/MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:CATHERINE
Last Name:HUTTER
Suffix:
Gender:F
Credentials:BS/MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16239 96TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-4029
Mailing Address - Country:US
Mailing Address - Phone:718-374-3032
Mailing Address - Fax:
Practice Address - Street 1:16239 96TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-4029
Practice Address - Country:US
Practice Address - Phone:718-374-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0-12146171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor