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Organization

CLINICAL PSYCHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW MARTIN HUTT PH.D. ABPP (OWNER)
(308) 632-8080
Entity
Organization

Contact information

Practice address
2208 BROADWAY, SCOTTSBLUFF, NE 69361-1970
(308) 632-8080
(308) 630-0821
Mailing address
2208 BROADWAY, SCOTTSBLUFF, NE 69361-1970
(308) 632-8080
(308) 630-0821

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4121
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026239400
NE
Enumeration date
02/06/2017
Last updated
02/06/2017
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