Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 28262 | TX |
NPI | 1003019134 |
---|---|
Provider Name | Ms. Lynette Edens Hutchins |
First Address | San Antonio, TX 78258-1919 |
Second Address | San Antonio, TX 78258-1919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 08/07/2007 |