Healthcare Provider Details

I. General information

NPI: 1851285480
Provider Name (Legal Business Name): ROBIN JEANNE HATLE CPHT-ADV, CSPT, CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OLD TOWN BLVD S STE 102
LANTANA TX
76226-3969
US

IV. Provider business mailing address

1661 COUNTY ROAD 220
GAINESVILLE TX
76240-8467
US

V. Phone/Fax

Practice location:
  • Phone: 940-464-4500
  • Fax: 940-464-4533
Mailing address:
  • Phone: 940-391-1245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number21352
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: