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NPI Code Detail

MEDICARE: JOCELYN HATCH M.A SLP

MEDICARE: JOCELYN HATCH M.A SLP
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
1235Z00000XSpeech-Language PathologistSP1786ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ST1654OTHERMESLP-CFY

General Provider Information

NPI Number : 1952529539
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN HATCH M.A SLP
Provider Business Mailing Address
First Line : 1121 FOREST AVE APT 2
Second Line :
City : PORTLAND
State : ME
Zip : 04103-3323
Country : US
Telephone Number : 207-632-2194
Fax Number :
Provider Business Practice Location Address
First Line : 50 NEW PORTLAND RD
Second Line :
City : GORHAM
State : ME
Zip : 04038-1542
Country : US
Telephone Number : 207-839-5757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2007
Last Update Date : 02/13/2008

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