Provider Demographics
NPI:1073288239
Name:HATCH, HEATHER E (BA, MTS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:E
Last Name:HATCH
Suffix:
Gender:F
Credentials:BA, MTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 N BAMBOO CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9675
Mailing Address - Country:US
Mailing Address - Phone:314-387-1362
Mailing Address - Fax:
Practice Address - Street 1:4720 N BAMBOO CIR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-9675
Practice Address - Country:US
Practice Address - Phone:314-387-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral