MEDICARE: MS. KATHRYN JAMIE HANCHETT M.C.P., L.P.C.

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
1	101YP2500X	Professional Counselor	3484	OK

General Provider Information

NPI Number	:	1932427549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN JAMIE HANCHETT M.C.P., L.P.C.

Provider Business Mailing Address
First Line	:	4601 SOUTH 'S' STREET
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-8104
Country	:	US
Telephone Number	:	580-304-2671
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 SOUTH 'S' STREET
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-8104
Country	:	US
Telephone Number	:	580-304-2671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2010
Last Update Date	:	05/06/2010

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