Healthcare Provider Details

I. General information

NPI: 1053163022
Provider Name (Legal Business Name): VICTORIA HATCHETT PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57950 LEAVENWORTH ST
MCCONNELL AFB KS
67221-3505
US

IV. Provider business mailing address

57950 LEAVENWORTH ST
MCCONNELL AFB KS
67221-3505
US

V. Phone/Fax

Practice location:
  • Phone: 316-759-2069
  • Fax:
Mailing address:
  • Phone: 316-759-2069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009550
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: