Provider Demographics
NPI:1730272782
Name:HUTCHISON, MICHELLE (MC, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14863 W CORTEZ ST
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5226
Mailing Address - Country:US
Mailing Address - Phone:623-330-9035
Mailing Address - Fax:
Practice Address - Street 1:12600 N 113TH AVE
Practice Address - Street 2:SUITE B-9
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1162
Practice Address - Country:US
Practice Address - Phone:623-330-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health