Provider Demographics
NPI:1699549691
Name:HUOT, ADAM CLIFFORD
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:CLIFFORD
Last Name:HUOT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 NORWAY PINES PL
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1253
Mailing Address - Country:US
Mailing Address - Phone:218-729-6480
Mailing Address - Fax:
Practice Address - Street 1:4560 NORWAY PINES PL
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-1253
Practice Address - Country:US
Practice Address - Phone:218-729-6480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN295741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical