Provider Demographics
NPI:1801921465
Name:HUTCHISON, LAURA WICKENS (PSYD, LLP, RPT)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:WICKENS
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:PSYD, LLP, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38345 WEST TEN MILE RD
Mailing Address - Street 2:STE 150
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335
Mailing Address - Country:US
Mailing Address - Phone:248-788-5754
Mailing Address - Fax:248-478-0435
Practice Address - Street 1:38345 W 10 MILE RD
Practice Address - Street 2:STE 150
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2867
Practice Address - Country:US
Practice Address - Phone:248-788-5754
Practice Address - Fax:248-478-0435
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical