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NPI Code Detail

MEDICARE: ANIYA BRIELLE HATTEN

MEDICARE: ANIYA BRIELLE HATTEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-22-201615GA

General Provider Information

NPI Number : 1184377012
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIYA BRIELLE HATTEN
Provider Business Mailing Address
First Line : 4920 ROSWELL RD STE 1
Second Line :
City : ATLANTA
State : GA
Zip : 30342-2684
Country : US
Telephone Number : 470-258-4050
Fax Number :
Provider Business Practice Location Address
First Line : 4920 ROSWELL RD STE 1
Second Line :
City : ATLANTA
State : GA
Zip : 30342-2684
Country : US
Telephone Number : 470-258-4050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2022
Last Update Date : 02/01/2022

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Directions to “ ANIYA BRIELLE HATTEN ” Practice Location

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