Provider Demographics
NPI:1730585969
Name:HUTCHINSON, CHARLA (BCBA)
Entity type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2081
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293-2081
Mailing Address - Country:US
Mailing Address - Phone:336-601-1810
Mailing Address - Fax:336-787-3991
Practice Address - Street 1:4551 W OLD HWY 64
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295
Practice Address - Country:US
Practice Address - Phone:336-601-1810
Practice Address - Fax:336-787-3991
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-13-13390103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst