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General NPI Number Information
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NPI Number | 1497470033
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Entity Type | Individual
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Provider Name | TRISTEN HYATT LPC, NCC,
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Gender | Female
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 3840 WESTMORELAND RD LOT 28
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City | CLEVELAND
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State | GA
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Zip | 30528-4867
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Country | US
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Telephone | 850-404-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 250 EAST JARRARD STREET, SUITE C PMB 166
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City | CLEVELAND
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State | GA
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Zip | 30528
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Country | US
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Telephone | 706-289-8255
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011078
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License Number State | GA
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