Healthcare Provider Details

I. General information

NPI: 1649715319
Provider Name (Legal Business Name): AMY HATZEL M.A., NAD-V
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15335 SILVER RUN RD
CATLETTSBURG KY
41129-8361
US

IV. Provider business mailing address

15335 SILVER RUN RD
CATLETTSBURG KY
41129-8361
US

V. Phone/Fax

Practice location:
  • Phone: 606-232-6391
  • Fax: 606-475-9200
Mailing address:
  • Phone: 606-739-5423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number0089
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number000071857
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: