Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY7049 | FL |
Y | 103G00000X | Clinical Psychologist | PY7049 | FL |
Y | 103TC0700X | Clinical Psychologist | PY7049 | FL |
N | 103TC1900X | Counseling Psychologist | PY7049 | FL |
NPI | 1598092504 |
---|---|
Provider Name | Jeffrey Paul Huttman |
First Address | Boca Raton, FL 33496-2473 |
Second Address | Boca Raton, FL 33431-7307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2009 |
Last Update Date | 13/05/2021 |