Provider Demographics
NPI:1700425915
Name:HUTTER, KATHLEEN M (NUTRITIONIST)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:HUTTER
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COLUMBIA LNDG
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:CT
Mailing Address - Zip Code:06237-1304
Mailing Address - Country:US
Mailing Address - Phone:860-455-8215
Mailing Address - Fax:
Practice Address - Street 1:11 COLUMBIA LNDG
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1304
Practice Address - Country:US
Practice Address - Phone:860-455-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist