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Organization

HUTNER, INC.

Active
Other names
The Ivy Group of Fort Wayne
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN DOUGLAS HUTNER PSY.D., HSPP (PRESIDENT)
(260) 341-5848
Entity
Organization

Contact information

Practice address
3240 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(260) 341-5848
(260) 755-5927
Mailing address
3240 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(260) 341-5848
(260) 755-5927

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041381A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200266510
IN
05
200288980
IN
05
200412990-A
IN
Enumeration date
01/02/2007
Last updated
01/31/2014
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