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General NPI Number Information
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NPI Number | 1003059304
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Entity Type | Individual
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Provider Name | MINDA HATLEY MA,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 8 MARY SCOTT PL
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City | GREENSBORO
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State | NC
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Zip | 27410-9718
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Country | US
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Telephone | 336-255-9588
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Fax |
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Provider Business Mailing Address
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Address Line | 8 MARY SCOTT PL
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City | GREENSBORO
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State | NC
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Zip | 27410-9718
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Country | US
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Telephone | 336-255-9588
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8131
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License Number State | NC
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