Provider Demographics
NPI:1033252085
Name:HATCHETT, THEOWAUNA LADORA
Entity Type:Individual
Prefix:
First Name:THEOWAUNA
Middle Name:LADORA
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DOVER GLENN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1819
Mailing Address - Country:US
Mailing Address - Phone:615-485-2677
Mailing Address - Fax:
Practice Address - Street 1:3310 PERIMETER HILL DRIVE
Practice Address - Street 2:
Practice Address - City:NAASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4123
Practice Address - Country:US
Practice Address - Phone:615-250-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health