Doctor Name: | DR. JESSICA M HUETT |
NPI Number: | 1053616995 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D., HSPP |
License Number: | 20042178A |
Business Practice Address: | 1501 State St New Albany, IN - 471504911 |
Business Phone Number: | 8129441550 |
Business Fax Number: | |
Mailing Address: | 1501 State St, NEW ALBANY |
State: | IN |
Postal Code: | 471504911 |
Phone Number: | 8129441550 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2011 |
NPI Last Update Date: | 01/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 20042178A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |