Provider Demographics
NPI:1780092486
Name:RUDO-HUTT, ANNA (PHD)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:RUDO-HUTT
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 1:141 N CENTRAL AVE
Mailing Address - Street 2:C/O WJCS
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1912
Mailing Address - Country:US
Mailing Address - Phone:914-949-7699
Mailing Address - Fax:914-949-3224
Practice Address - Street 1:141 N CENTRAL AVE
Practice Address - Street 2:C/O WJCS
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1912
Practice Address - Country:US
Practice Address - Phone:914-949-7699
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist