Provider Demographics
NPI:1033952890
Name:HUTSON, HOLLI MICHELLE
Entity type:Individual
Prefix:
First Name:HOLLI
Middle Name:MICHELLE
Last Name:HUTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 KINGS MILL CT
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4906
Mailing Address - Country:US
Mailing Address - Phone:404-423-8488
Mailing Address - Fax:
Practice Address - Street 1:555 COLONIAL PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3766
Practice Address - Country:US
Practice Address - Phone:678-856-5042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker