Basic Information
| Provider Information | |||||||||
| NPI: | 1003011669 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTCHISON | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | DELBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 978 WOODLAND CIR | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214095309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107575997 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 978 WOODLAND CIR | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214095309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107575997 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 00731 | MD | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.