Provider Demographics
NPI:1154372159
Name:HUTT, CARLA D (ND)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:D
Last Name:HUTT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 ASPETUCK TRL
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2810
Mailing Address - Country:US
Mailing Address - Phone:860-558-4009
Mailing Address - Fax:844-331-2026
Practice Address - Street 1:258 S MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1815
Practice Address - Country:US
Practice Address - Phone:860-558-4009
Practice Address - Fax:844-331-2026
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH87175F00000X
CT000197175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000197OtherCONNECTICARE
CT110000197CT02OtherANTHEM BC/BS
CTP3536685OtherOXFORD
CTOV8179OtherHEALTHNET