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General NPI Number Information
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NPI Number | 1831308717
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Entity Type | Individual
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Provider Name | CYNTHIA A HATAWAY LPC
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 301 ANDREWS AVE SUITE T-125
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City | FORT RUCKER
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State | AL
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Zip | 36362-5333
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Country | US
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Telephone | 334-255-7797
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Fax | 334-255-7923
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Provider Business Mailing Address
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Address Line | 1207 COUNTY ROAD 452
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City | KINSTON
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State | AL
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Zip | 36453-4536
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Country | US
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Telephone | 334-565-9877
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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 | 897
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License Number State | AL
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