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General NPI Number Information
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NPI Number | 1205621232
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Entity Type | Individual
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Provider Name | KRISTIN HATLEY MT
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 4147 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-6741
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Country | US
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Telephone | 505-553-0555
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Fax | 505-461-0137
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Provider Business Mailing Address
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Address Line | 305 HALE CIR SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-0305
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Country | US
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Telephone | 505-235-4869
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Fax | 505-461-0137
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT9526
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License Number State | NM
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