MEDICARE: PARADISE HATTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1821788274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARADISE HATTON

Provider Business Mailing Address
First Line	:	9240 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5141
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

Provider Business Practice Location Address
First Line	:	9240 N SAM HOUSTON PKWY E STE 110
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-5141
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/09/2023

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Directions to “ PARADISE HATTON ” Practice Location

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