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Individual

DR. KELLY STEWART HUTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D., HSPP

Contact information

Practice address
11143 PARKVIEW PLAZA DR STE 320, FORT WAYNE, IN 46845-1728
(260) 266-5370
(260) 266-5379
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041507A
IN

Other

Enumeration date
09/09/2010
Last updated
10/11/2022
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