=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982198578
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TONIA MARIE HASTINGS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2018
-----------------------------------------------------
Last Update Date | 06/18/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 WESTWAY PL
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76018-5245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-516-9100
-----------------------------------------------------
Fax | 817-516-9102
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 WESTWAY PL STE 530
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76018-1000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-516-9100
-----------------------------------------------------
Fax | 817-516-9102
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 78036
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------